Who will become my co-residents? The role of attractiveness of institutional care in the changing demand for long-term care institutions |
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| Institution: | 1. Erasmus University, Erasmus School of Health Policy and Management, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands;2. Amsterdam Public Health Research Institute and Department of Epidemiology and Biostatistics, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands;1. Ufuk University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Turkey;2. Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Ankara, Turkey;1. Clinical Laboratory Medicine, Fujita Health University Graduate School of Health Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan;2. Department of Hygiene, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan;3. Department of Biochemistry, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan;4. Department of Health Sciences, Kansai University of Welfare Sciences Faculty of Health and Welfare, 3-11-1 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan;5. Department of Education, Kyoto Women’s University Faculty of Human Development and Education, 35 Kitahiyoshi-cho, Imakumano, Higashiyama-ku, Kyoto, 605-8501, Japan;6. Department of Clinical Biochemistry, Fujita Health University School of Health Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan;7. Department of Preventive Medical Sciences, Fujita Health University School of Health Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan;1. Department of Geriatric Cardiology, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, China;2. Department of Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China;3. Department of Rehabilitation, Chinese PLA General Hospital, Beijing, China;4. International Medical Center, Chinese PLA General Hospital, Beijing, China;1. University of Florida College of Pharmacy, Department of Pharmaceutical Outcomes & Policy, PO Box 100496, Gainesville, FL 32610-0496, United States;2. University of Florida Health Physicians, PO BOX 100354, Gainesville, FL 32610-0354, United States;3. Saint Louis University, College of Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO 63104, United States;4. Baptist MD Anderson Cancer Center, Department of Urologic Surgery, 1235 San Marco Blvd., Jacksonville, FL 32207, United States;5. Washington University in St. Louis School of Medicine, Department of Medicine, 4523 Clayton Ave., Campus Box 8051, St. Louis, MO 63110, United States;6. SSM Health, Department of Clinical Analytics and Insights, 10101 Woodfield Lane, St. Louis, MO 63132, United States;1. Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore;2. Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore;3. Geriatric Education and Research Institute, Singapore;4. Department of General Medicine, Sengkang General Hospital, Singapore;5. Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore;6. Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore;7. Ageing Research Institute for Society and Education (ARISE), Nanyang Technological University, Singapore |
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| Abstract: | BackgroundIn several OECD countries the percentage of people over 80 in LTC institutions has been declining for more than a decade, despite population ageing. The standard model to explain healthcare utilization, the Andersen model, cannot explain this trend. We extend the Andersen model by including proxies for the relative attractiveness of community living compared to institutional care. Using longitudinal data on long-term care use in the Netherlands from 1996 to 2012, we examine to what extent a decline in institutional care is associated with changes in perceived attractiveness of institutional LTC care compared to community living.MethodsWith a Blinder–Oaxaca decomposition regression, we decomposed the difference in admission to LTC institutions between the period 1996–1999 and 2009–2012 into a part that accounts for differences in predictors of the Andersen model and an “unexplained” part, and investigate whether the perceived attractiveness of institutional care reduces the size of the unexplained part.ResultsWe find that factors related to the perceived attractiveness of institutional care compared to community living explains 12.8% of the unexplained negative time trend in admission rates over the total period (1996–2012), and 19.1–19.2% over shorter time frames.DiscussionOur results show that changes in the perceived attractiveness of institutional LTC may explain part of the decline in demand for institutional care. Our findings imply that policies to encourage community living may have a self-reinforcing effect. |
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| Keywords: | Long-term care Independent living Nursing homes |
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