Transitions in Long-Term Care

Temkin‐Greener, Helena; Meiners, Mark R.

doi:10.1093/geront/35.2.196

Cited by 32 publications

(20 citation statements)

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“…Among the general population, physical and/or mental disability have consistently been found to be the primary predictor for nursing home placement. Health‐related factors, including functional disabilities of the older person, were found to be more important predictors than demographic characteristics or support system in the choice of different care modalities in this study (Bauer, 1996; Temkin‐Greener & Meiners, 1995). However, the relative importance of health‐related factors was lessened or was even insignificant in other studies.…”

Section: Discussionmentioning

confidence: 76%

Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Lee¹,

Kovner²,

Mezey³

et al. 2001

Public Health Nursing

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This research was designed to explore factors that affect the choice of long-term care modalities in the older population and to discuss the appropriate target population of home health care services within the entire long-term care system. The study subjects' activities of daily living limitations, cognitive status, and sociodemograhic data at the time of admission were obtained from retrospective chart reviews. The sample included 134 older subjects who were receiving long-term care from a Long-Term Home Health Care Program or a nursing home in New York City. The results indicated that Long-Term Home Health Care Program use by older persons was characterized by a higher rate of being admitted from private homes, less cognitive impairments, less limitations in activities of daily living, and younger age than older patients who were nursing home residents. Consequently, in the choice of different care modalities, health-related factors of the older population were found to be more important predictors than sociodemographic characteristics or support system. The implication to both nurses and researchers is the development of eligibility criteria that captures the unique characteristics of disabled older persons in each of the different long-term care programs to serve them better in a cost-effective manner.

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Section: Discussionmentioning

confidence: 76%

Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Lee¹,

Kovner²,

Mezey³

et al. 2001

Public Health Nursing

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“…The presence or absence of family members living with the individual who may provide support, and their caregiving ability, have been reported to have an impact on decline [69,70] and on hospitalisation and institutionalisation [26,52,60,71,72]. These factors could not be analysed in our study because the data were not available, but they should be included in future studies.…”

Section: Limitationsmentioning

confidence: 99%

Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

Tomita

Yoshimura

Ikegami

2010

BMC Health Serv Res

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BackgroundThis population-based retrospective cohort study aimed to clarify the impact of home and community-based services on the hospitalisation and institutionalisation of individuals certified as eligible for long-term care insurance (LTCI) benefits.MethodsHealth insurance data and LTCI data were combined into a database of 1,020 individuals in two farming communities in Hokkaido who were enrolled in Citizen's Health Insurance. They had not received long-term care services prior to April 1, 2000 and were newly certified as eligible for Long-Term Care Insurance benefits between April 1, 2000 and February 29, 2008. The analysis covered 565 subjects who had not been hospitalised or institutionalised at the time of first certification of LTCI benefits. The adjusted hazard ratios (HRs) of hospitalisation or institutionalisation or death after the initial certification were calculated using the Cox proportional hazard model. The predictors were age, sex, eligibility level, area of residence, income, year of initial certification and average monthly outpatient medical expenditures, in addition to average monthly total home and community-based services expenditures (analysis 1), the use or no use of each type of service (analysis 2), and average monthly expenditures for home-visit and day-care types of services, the use or no use of respite care, and the use or no use of rental services for assistive devices (analysis 3).ResultsUsers of home and community-based services were less likely than non-users to be hospitalised or institutionalised. Among the types of services, users of respite care (HR: 0.71, 95% confidence interval [CI]: 0.55-0.93) and rental services for assistive devices (HR: 0.70, 95% CI: 0.54-0.92) were less likely to be hospitalised or institutionalised than non-users. For those with relatively light needs, users of day care were also less likely to be hospitalised or institutionalized than non-users (HR: 0.77, 95% CI: 0.61-0.98).ConclusionsRespite care, rental services for assistive devices and day care are effective in preventing hospitalisation and institutionalisation. Our results suggest that home and community-based services contribute to the goal of the LTCI system of encouraging individuals certified as needing long-term care to live independently at home for as long as possible.

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“…This increases the costs to providers and lowers profitability. The literature confirms that accurate estimates of financial risk to the providers of LTCI are hard to find (Temkin-Greener & Meiners 1995).…”

Section: Issues For Ltci-based Partnership Schemesmentioning

confidence: 79%

“…According to detailed research carried out in North America, it is influenced by many factors including age, race, gender, functional status (physical and mental), income, morbidity, acute care use and informal supports (Crown et al 1992). Increasing age and female gender are among the strongest predictive factors, along with level of social support (especially living without a spouse at home) and the onset of disabling chronic disease (Shapiro & Tate 1988, Temkin-Greener & Meiners 1995. In Britain, similar factors are likely to operate, but local authority welfare policies will also be influential.…”

Section: Predicting the Need For Long-term Carementioning

confidence: 99%

Exploring shared options in funding long-term care for older people

Davey

1998

Health Soc Care Community

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Policy-makers throughout the world are faced with the question of how long-term care for dependent elderly people is to be funded. This paper discusses possible sources of funding and a variety of policy approaches which have been taken by members of the Organisation for Economic Cooperation and Development, with particular emphasis on Britain. It concentrates on options which share costs between the users (and their families) and the state. Details are provided of schemes involving private sector insurance and equity release products. A variety of issues arise from the proposed use of such 'partnership' schemes in Britain. Discussion of these issues draws in aspects of the wider social and policy contexts.

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Transitions in Long-Term Care

Cited by 32 publications

References 0 publications

Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Impact of home and community-based services on hospitalisation and institutionalisation among individuals eligible for long-term care insurance in Japan

Exploring shared options in funding long-term care for older people

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