Format

Send to

Choose Destination
BMC Geriatr. 2019 Oct 24;19(1):286. doi: 10.1186/s12877-019-1291-z.

Transitioning of older Australian women into and through the long-term care system: a cohort study using linked data.

Author information

1
Priority Research Centre for Generational Health and Ageing, University of Newcastle, West Wing, Level 4, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia. MdMijanur.Rahman@uon.edu.au.
2
Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, Australia. MdMijanur.Rahman@uon.edu.au.
3
Department of Statistics, Comilla University, Comilla, Bangladesh. MdMijanur.Rahman@uon.edu.au.
4
Priority Research Centre for Generational Health and Ageing, University of Newcastle, West Wing, Level 4, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
5
Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, Australia.

Abstract

BACKGROUND:

Over two-thirds of older Australians use different types/levels of aged care at some point in later life. Our aims were to estimate transitional probabilities and to identify risk factors influencing the movement between different levels of long-term care.

METHODS:

The sample consisted of 9007 women from the 1921-26 birth cohort of the Australian Longitudinal Study on Women's Health. Transitional probabilities between different levels of long-term care were estimated using a continuous-time Markov model.

RESULTS:

An 11-fold transition rates ratio was observed for the movement from non-user to home and community care (HACC) versus non-user to residential aged care (RAC). The predicted probabilities of remaining in the non-user state, HACC, and RAC after 10 years from the baseline were .28, .24, and .11, respectively. While the corresponding probabilities of dying from these states were .36, .65, and .90. The risk of transitioning from the non-user state to either HACC or RAC was greater for participants who were older at baseline, widowed, living outside of major cities, having difficulties in managing income, or having chronic condition, poor/fair self-rated health, or lower SF-36 scores (p < .05).

CONCLUSION:

Women spend a substantial period of their later life using long-term care. Typically, this will be in the community setting with a low level of care. The transition to either HACC or RAC was associated with several demographic and health-related factors. Our findings are important for the planning and improvement of long-term care among future generations of older people.

TRIAL REGISTRATION:

Not applicable.

KEYWORDS:

Home and community care; Markov multi-state model; Residential aged care; Risk factors; Transitional probability

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center