[en] [en] BACKGROUND: This study examines predictors of nursing home admission (NHA) in Belgium in order to contribute to a better planning of the future demand for nursing home (NH) services and health care resources.
METHODS: Data derived from the Belgian 2013 health interview survey were linked at individual level with health insurance data (2012 tot 2018). Only community dwelling participants, aged ≥65 years at the time of the survey were included in this study (n = 1930). Participants were followed until NHA, death or end of study period, i.e., December 31, 2018. The risk of NHA was calculated using a competing risk analysis.
RESULTS: Over the follow-up period (median 5.29 years), 226 individuals were admitted to a NH and 268 died without admission to a NH. The overall cumulative risk of NHA was 1.4, 5.7 and 13.1% at respectively 1 year, 3 years and end of follow-up period. After multivariable adjustment, higher age, low educational attainment, living alone and use of home care services were significantly associated with a higher risk of NHA. A number of need factors (e.g., history of falls, suffering from urinary incontinence, depression or Alzheimer's disease) were also significantly associated with a higher risk of NHA. On the contrary, being female, having multimorbidity and increased contacts with health care providers were significantly associated with a decreased risk of NHA. Perceived health and limitations were both significant determinants of NHA, but perceived health was an effect modifier on limitations and vice versa.
CONCLUSIONS: Our findings pinpoint important predictors of NHA in older adults, and offer possibilities of prevention to avoid or delay NHA for this population. Practical implications include prevention of falls, management of urinary incontinence at home and appropriate and timely management of limitations, depression and Alzheimer's disease. Focus should also be on people living alone to provide more timely contacts with health care providers. Further investigation of predictors of NHA should include contextual factors such as the availability of nursing-home beds, hospital beds, physicians and waiting lists for NHA.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Berete, Finaba ; Université de Liège - ULiège > Unité de recherche Santé publique, épidémiologie et économie de la santé (URSAPES) ; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium. finaba.berete@sciensano.be
Demarest, Stefaan; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
Charafeddine, Rana; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
De Ridder, Karin; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
Van Oyen, Herman; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium ; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
Bruyère, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > > Service de médecine de l'appareil locomoteur
Van der Heyden, Johan; Department of Epidemiology and public health, Sciensano, Juliette Wytsmanstraat 14, 1050, Brussels, Belgium
Language :
English
Title :
Predictors of nursing home admission in the older population in Belgium: a longitudinal follow-up of health interview survey participants.
This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The Belgian Health Interview Survey (BHIS) is financed by the Federal and Inter-Federated Belgian Public Health authorities. The linkage between BHIS data and the Belgian Compulsory Health Insurance data is financed by the National Institute for Health and Disability Insurance.
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