Comparing the resident populations of private and public long-term care facilities over a 15-year period: a study from Quebec, Canada

Incidence of Pressure Injury Among Older Adults Transitioning from Long-term Care to the ED

OBJECTIVE

To identify sociodemographic, health condition, and organizational/process factors associated with pressure injury (PI) incidence during older adults' emergency transitions from long-term care (LTC) to the ED.

METHODS

Emergency transitions were tracked for older adults within included LTC facilities to participating EDs in two urban centers located in provinces in Canada. Binary logistic regression was used to examine the influence of sociodemographic, service use, and client health and function factors on the incidence of PIs during transitions from LTC facilities to EDs.

RESULTS

Having a mobility issue (odds ratio [OR], 4.318; 95% CI, 1.344-13.870), transitioning from a publicly owned versus a nonprofit volunteer LTC facility (OR, 4.886; 95% CI, 1.157-20.634), and time from ED arrival to return to LTC being 7 to 9 days (OR, 41.327; 95% CI, 2.691-634.574) or greater than 9 days (OR, 77.639; 95% CI, 5.727-1,052.485) significantly increased the odds of experiencing a new skin injury upon return to LTC. A higher number of reported reasons for emergency transition (up to 4) significantly decreased the odds of a new PI upon return to LTC (OR, 0.315; 95% CI, 0.113-0.880).

CONCLUSIONS

The study findings can be used to identify LTC residents at increased risk for developing new skin injuries during an emergency transition, namely, those with mobility impairment, those requiring inpatient care for 6 or more days, and those transitioning from publicly owned LTC facilities. Evaluating the uptake and effectiveness of single-pronged and multipronged interventions such as visual cues for patient turning through online monitoring, consistent risk assessments, and improved nutrition in all care settings are vital next steps in preventing skin injuries in this population.

Predictors of long-term care use - informal home care recipients versus private and public facilities residents in Poland

BACKGROUND

The population aging, together with the shrinking caring potential of families, is a major challenge for social policy in the coming years. The aim of the study is to identify the factors that determine not only the use of long-term care (LTC) but also the selection of individual types of such care in Poland.

METHODS

Using unique data collected from inpatient LTC facilities in Poland and the Survey on Health, Ageing and Retirement in Europe (SHARE) database, we estimate logistic regressions explaining the choice of LTC solution.

RESULTS

Our results suggest that social inequalities play a role in choosing the type of LTC. Better educated people choose private institutions, while people without support network use more often social residential homes. The impact of multimorbidity on choosing different types of inpatient facilities is limited, thus the number of ADL limitations remains a better indicator of long term care utilization.

CONCLUSIONS

The study confirms that social inequalities influence decisions about the choice of LTC. However, multi-morbidity is a predictor of using LTC to a limited extent. The differences in LTC selection determinants between women and men are noticeable.