- Title
- Older women's patterns of home and community care use and transition to residential aged care: an Australian cohort study
- Creator
- Rahman, Md Mijanur; Byles, Julie E.
- Relation
- Maturitas Vol. 131, Issue 2020, p. 28-33
- Publisher Link
- http://dx.doi.org/10.1016/j.maturitas.2019.10.004
- Publisher
- Elsevier Ireland
- Resource Type
- journal article
- Date
- 2020
- Description
- Objective: To examine whether patterns of home and community care (HACC) use and person-based characteristics were associated with time to enter permanent residential aged care (RAC). Study design: A prospective cohort study. The sample consisted of 8062 participants of the Australian Longitudinal Study on Women's Health who used HACC services between 2001 and 2014. Main outcome measures: Time from first HACC use to enter permanent RAC. The median follow-up time was 63 months. Factors associated with time to enter RAC were identified using competing risk regression models. Results: Of the 8062 participants, 60% belonged to the 'basic HACC' group, who used few services minimally; 16% belonged to the 'moderate HACC' group, who predominantly used domestic assistance with moderate use of other services; and 24% belonged to the 'complex HACC' group, who used many services frequently. Being a member of the complex HACC group was associated with a lower cumulative incidence of RAC than basic or moderate HACC (chances 15% versus 30% by the median observation period, p < 0.01). Living in a remote/outer region (sub-distributional hazard ratio (sdHR) = 0.83, 95%CI: 0.74 - 0.93) was associated with delayed admission to RAC. Meanwhile, earlier admission was associated with living in an apartment (sdHR = 1.29, 95%CI: 1.20-1.40) or a retirement village (sdHR = 1.54, 95%CI = 1.38-1.72), having a physical functioning score <40 (sdHR = 1.16, 95%CI = 1.05-1.25), and falls with injury (sdHR = 1.15, 95%CI = 1.05-1.25). Conclusions: Our findings highlight the importance of providing more community care services, age-friendly housing, falls prevention and physical activity programs to reduce inappropriate admission to RAC.
- Subject
- community aged care; residential aged care; older women; linked data; competing risk analysis
- Identifier
- http://hdl.handle.net/1959.13/1422670
- Identifier
- uon:37864
- Identifier
- ISSN:0378-5122
- Language
- eng
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