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- Page navigation anchor for RE: Elevated hospitalization rates previously shown for assisted living residents in AlbertaRE: Elevated hospitalization rates previously shown for assisted living residents in Alberta
The study by Manis et al. examining the rates of health service use among residents of Ontario retirement homes compared with older adults residing in long-term care (LTC) highlights an important and persisting issue for the Canadian healthcare system.
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During 2006-2009 we conducted a prospective (primary data) cohort study of the health and social needs and health outcomes of 1,089 older residents in 59 designated assisted living (AL) homes compared with 1,000 older residents in 54 LTC homes in Alberta. Our designated AL cohort was population-based (residents from all but 1 eligible home in the province and from all 5 health regions were included). The comprehensive data collected on them at baseline and 1-year follow-up included linkage with provincial health administrative data. As with the Ontario retirement home cohort, our Alberta AL resident cohort was of advanced age (mean 85 years) and predominantly female (77%) though we observed a much higher prevalence of dementia (57% compared with 38% in the Ontario study).
In our first report,1 we noted that AL residents were significantly more likely than LTC residents to have had an inpatient acute care hospitalization (12% vs 5%, respectively) or emergency department visit (16% vs 6%, respectively) in the previous 90 days but less likely to have had at least one physician visit in the same time period (63% vs 90%). In subsequent publications,2,3 we showed that the incidence of hospital admission over 1 year was...Competing Interests: None declared.References
- 1. Strain LA, Maxwell CJ, Wanless D, et al. Designated Assisted Living (DAL) and Long-Term Care (LTC) in Alberta: Selected Highlights from the Alberta Continuing Care Epidemiological Studies (ACCES). Edmonton, AB: ACCES Research Group, University of
- Alberta, 2011. http://hdl.handle.net/10402/era.23779
- 2. Hogan DB, Amuah JE, Strain LA, et al. High rates of hospital admission among older residents in assisted living facilities: opportunities for intervention and impact on acute care. Open Med 2014;8(1):33-45.
- 3. Maxwell CJ, Amuah JE, Hogan DB, et al. Elevated hospitalization risk of assisted living residents with dementia in Alberta, Canada. J Am Med Dir Assoc 2015 16(7):568-77.
- Page navigation anchor for RE: rates reflect under servicing in long term care?RE: rates reflect under servicing in long term care?
I would hypothesize that these results reflect the unmet medical needs of those with cognitive impairment in LTC. Those in Assisted living can self identify their needs and access appropriate care. Those in LTC are subject to rationed visits and an inability to ask for an ER visit.
Both settings need a better approach.
Frailty is certain to increase across the spectrum of residential settings for the elderly. With frailty comes increased complexity and increased need for access to care. I would argue monthly visits to those in LTC is shockingly inadequateCompeting Interests: None declared.References
- . 2022;:-.
- Page navigation anchor for RE: RAtes of health services use among retirement home residentsRE: RAtes of health services use among retirement home residents
Great article. As a family doctor for 50 years looking after numerous retirement and nursing homes and having relatives in the system I think one reason is that residents and families have more desire for care . In nursing homes they are sicker and are more accepting of in home care and don't push as much for transfer to hospital.
Competing Interests: None declared.References
- . 2022;:-.