Association of health-care and long-term care resources for patients with dementia with institutionalization and death: Evidence from South Korea

초록

INTRODUCTIONThe role of community characteristics on supporting the community residence of older adults with dementia has received little attention. This study explores the association of community resources with extending older adults' stay in community settings and mitigating premature institutionalization and mortality.METHODSUsing data from 286,940 patients with dementia in South Korea, this study used Cox proportional hazard models to analyze the relationships among community management, institutionalization, mortality rates, and the availability of long-term care and medical resources at the municipal level, adjusting for individual factors.RESULTSIncreased availability of home care nurses and physicians was significantly associated with enhanced community management, showing a noticeable decrease in mortality and institutionalization risk. Additionally, more home care social workers were associated with a reduced institutionalization risk, while an excess of medical and long-term care facilities was linked to a heightened institutionalization risk.DISCUSSIONThese findings underscore the importance of health-care resources aligning with the specific needs of patients with dementia.Highlights Local health-care resources may affect dementia patients' community residence. Results reveal physicians and home case nurses lower institutionalization and death. Study findings indicate home care social workers also reduce institutionalization. But, more hospital beds and long-term care facilities increase institutionalization. This underscores the need for nuanced approaches to community-based care.

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