Day care vs home care: Effects on functional health outcomes among long‐term care beneficiaries with dementia in Korea

Abstract

Objectives First, to compare changes in cognitive function, behavioral symptoms, and physical function for Korean Long‐Term Care Insurance (LTCI) beneficiaries with dementia in day care (DC) and home care (HC) settings over 1 year. Second, to examine the association between LTCI service type and the aforementioned health outcomes. Methods A retrospective matched cohort study was conducted using the national data set of the National Health Insurance Service in Korea. We identified 7822 beneficiaries with dementia who received either DC or HC services consistently for 1 year from 2008 to 2009. The propensity score matching method was used, yielding 416 participants in each group. Paired samples t‐tests and logistic regression analyses were conducted. Results Baseline differences between the two groups are present. According to multiple regression models, DC, when compared with HC, was related to less deterioration in cognitive and physical function but was associated with less improved behavioral symptoms 1 year after the LTCI enrollment. In the comparison between matched cohorts, DC, when compared with HC, was associated with less cognitive decline, less disability progression, and similar decrease in behavioral symptoms. Conclusions Cognitive function and disability declined less in the DC group, compared with the HC group. Conversely, behavioral symptoms showed a similar decrease between the two groups after 1‐year follow‐up. Further research is necessary to examine key features of DC services that have helped delay functional deterioration and alleviate behavioral symptoms.

Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan

“…This allows for determination of a causal relevance of health status and medical care utilization to be more representative [18]. There are studies analyzing the effectiveness of LTC systems using nationally-established datasets [21][22][23]. These results could provide an empirical basis for specific adjustments to policies and resource allocation.…”

<p>Effect Evaluation of the Long-Term Care Insurance (LTCI) System on the Health Care of the Elderly: A Review</p>

“… 17 Lee et al compared the changes in cognitive function, behavioral symptoms, and physical function of Korean LTCI care and individual care in 1 year and found that the elderly experienced less cognitive decline and decreased disability progression in LTCI care. 18 Milte et al found a strong association between processes of care delivery and quality of life of care recipients. 19 All the theoretical research is becoming more and more in-depth, which were conducted from the perspectives of different age groups, nursing time, and health recovery degree, etc.…”

“…It is found that the hazard ratio of participant death of those using long-term care services was significantly lower than for those who did not use these services. Lee et al (2019) 18 Int J Geriatr Psychiatry Korea Logistic regression 2008–2009 The propensity score matching method was used, yielding 416 participants in each group. Paired samples t‐tests and logistic regression analyses were conducted and found that cognitive function and disability declined less in the LTCI care group.…”

Development and Validation of a Person-Centered Care Assessment Questionnaire for Daycare Centers for Older Adults

“…Moreover, the fact that longer use of daycare services delays entry into care facilities or residential care hospitals ( Lee, 2006 ) also suggests that there is a need to improve older adults’ satisfaction with daycare services. For the care of older adults with dementia, cognitive function declined less in the daycare group than in the homecare group; however, conversely, behavioral symptoms showed a similar decrease between the two groups ( Lee et al, 2019 ).…”