The impact of different patterns of home- and community-based services on nursing home admission: National data from Taiwan

Ying Chieh Wang, Hsiao Wei Yu, Shih Cyuan Wu, Su Yuan Chan, Ming Chin Yang, Yue Chune Lee, Ya Mei Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: This study had two aims: (a) to identify the different patterns of use of home- and community-based services (HCBS) among older adults in Taiwan, and (b) to examine the effects of the different use patterns on HCBS recipients’ use of institutional long-term care services. Methods: The study analyzed cohort data from Taiwan's first National 10-Year Long-Term Care Plan database and from National Health Insurance Claim Data. We extracted baseline information on older adults who were first evaluated for and prescribed HCBS from 2010 through 2013 (N = 71,260). We used latent class analysis to specify the underlying subgroups of recipients with similar patterns of HCBS use. We used hierarchical multinomial logistic regression to examine the effect of the different use patterns on the risk of institutional (e.g., nursing home) placement from 4 to 15 months after initial HCBS evaluation. Results: Four subgroups of HCBS recipients were identified, with patterns of home-based personal care (PC), home-based personal care and medical care (PC/MC), home-based medical care (MC), and community care services. Compared to the home-based PC/MC group, people in the home-based MC group had lower risk (OR = 0.54) and people in the community care group had higher risk (OR = 1.76) of admission to a nursing home. Conclusions: Study findings may provide insights for policy makers regarding the usefulness of integrating medical care and other types of long-term care services into adult day care.

Original languageEnglish
Article number113679
JournalSocial Science and Medicine
Volume270
DOIs
StatePublished - Feb 2021

Keywords

  • Health outcomes
  • Health services use
  • Latent class analysis
  • Living arrangements
  • Long-term care

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