Gender differences in home care clients and admission to long-term care in Ontario, Canada: a population-based retrospective cohort study

BMC Geriatrics

Research Article

Jacqueline Forrester¹  Ximena Camacho¹  Sudeep S Gill²  Susan E Bronskill³  Andrea Gruneir⁴ 

[1] Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;Departments of Medicine and Community Health and Epidemiology, Queen’s University, Kingston, Ontario, Canada;Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada;Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada;Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada;

关键词: Older women;    Older men;    Home care;    Transitions;    Informal care;    Long-term care placement;    Nursing homes;   

DOI  :  10.1186/1471-2318-13-48

 received in 2012-12-18, accepted in 2013-04-23,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHome care is integral to enabling older adults to delay or avoid long-term care (LTC) admission. To date, there is little population-based data about gender differences in home care users and their subsequent outcomes. Our objectives were to quantify differences between women and men who used home care in Ontario, Canada and to determine if there were subsequent differences in LTC admission.MethodsThis is a population-based retrospective cohort study. We identified all adults aged 76+ years living in Ontario and receiving home care on April 1, 2007 (baseline). Using the Resident Assessment Instrument – Home Care (RAI-HC) linked to other databases, we characterized the cohort by living condition, health and functioning, and identified all acute care and LTC use in the year following baseline.ResultsThe cohort consisted of 51,201 women and 20,102 men. Women were older, more likely to live alone, and more likely to rely on a child or child-in-law for caregiver support. Men most frequently identified a spouse as caregiver and their caregivers reported distress twice as often as women’s caregivers. Men had higher rates of most chronic conditions and were more likely to experience impairment. Men were more likely to be admitted to hospital, to have longer stays in hospital, and to be admitted to LTC.ConclusionsUnderstanding who uses home care and why is critical to ensuring that these programs effectively reduce LTC use. We found that women outnumbered men but that men presented with higher levels of need. This detailed gender analysis highlights how needs differ between older women, men, and their respective caregivers.

【 授权许可】

CC BY   
© Gruneir et al.; licensee BioMed Central Ltd. 2013