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Health Care Services Use in Assisted Living: A Time Series Analysis*

  • Kimberlyn M. McGrail (a1) (a2), Meredith B. Lilly (a1), Margaret J. McGregor (a1) (a3), Anne-Marie Broemeling (a1) (a4), Kia Salomons (a1), Sandra Peterson (a1), Rachael McKendry (a1) and Morris L. Barer (a1) (a2)...

Abstract

This article describes British Columbia’s regulatory model for assisted living and used time series analysis to examine individuals’ use of health care services before and after moving to assisted living. The 4,219 assisted living residents studied were older and predominantly female, with 73 per cent having one or more major chronic conditions. Use of health care services tended to increase before the move to assisted living, drop at the time of the move (most notably for general practitioners, medical specialists, and acute care), and remain low for the 12-month follow-up period. These apparent positive effects are not trivial; the cohort of 1,894 assisted living residents used 18,000 fewer acute care days in the year after, compared to the year before, their move. Future research should address whether and how assisted living affects longer-term pathways of care for older adults and ultimately their function and quality of life.

Cet article décrit le modèle réglementaire de la Colombie-Britannique pour l’aide à la vie autonome et était basée sur une analyse des séries chronologiques qui a examiné l’utilisation individuelle des services de soins de santé avant et après leur arrivée en résidence-services. Les 4 219 résidents étudiés dans résidences assistées étaient vieilles et surtout des femmes, 73 pour cent d’entre eux ayant une ou plusieurs principales maladies chroniques. L’utilisation des services de soins de santé a eu la tendance à augmenter avant le passage à la vie autonome, de diminuer au moment du déménagement (notamment pour les médecins généralistes, les médecins spécialistes, et les soins actifs), et de rester faible au cours des 12 mois de la période suivie. Ces effets positifs apparents ne sont pas insignifiantes; la cohorte de 1 894 résidents de la vie assistée utilisaient moins de 18 000 jours de soins actifs dans l’année après, par rapport à l’année précédente, de leur déménagement. La recherche dans l’avenir devrait examiner si et comment aide à la vie autonome affecte à long terme les voies de soins de santé pour les personnes âgées et, finalement, comment leur fonction et la qualité de la vie sont touchés.

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Corresponding author

Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Kimberlyn M. McGrail, Ph.D. Centre for Health Services and Policy Research 201-2206 East Mall Vancouver, BC V6T 1Z3 (kmcgrail@chspr.ubc.ca)

Footnotes

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*

Funding and access to data for this project were provided by the British Columbia Ministry of Health. We are grateful to our colleagues at the Ministry, the Provincial Home and Community Care Council, the Council’s Standing Committee on Assisted Living, and others who provided thoughtful comments on the research as it progressed. Thanks as well to the reviewers whose careful reviews helped to improve the article. Any errors remain the responsibility of the authors.

Footnotes

References

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Alzheimer Society of Canada. (2010). Rising tide: The impact of dementia on Canadian society. Toronto: The Alzheimer Society of Canada.
BC Ministry of Health. (2012). Ministry of Health 2012/13 – 2014/15 service plan. Victoria, BC: BC Ministry of Health.
BC Ministry of Health. (n.d.a). Assisted Living Registry. Retrieved 14 April 2011 fromhttp://www.health.gov.bc.ca/assisted/mandate.html.
BC Ministry of Health. (n.d.b). Assisted Living Registrant Handbook. Retrieved 30 April 2012 fromhttp://www.health.gov.bc.ca/assisted/publications.html.
BC Ministry of Health. (n.d.c). BC Home and Community Care Policy Manual. Retrieved 30 April 2012 fromhttp://www.health.gov.bc.ca/hcc/policy-manual.html.
BC Ministry of Health Services, BC Ministry of Health Planning. (2002). Report on Health Authority Performance Agreements 2002/03. Victoria, BC: British Columbia Ministry of Health Services.
Canadian Centre for Elder Law. (2008). Discussion paper on assisted living: Past, present and future legal trends in Canada. Vancouver, BC: British Columbia Law Institute.
Carstairs, S., & Keon, W.J. (2009). Canada’s aging population: Seizing the opportunity. Special Senate Committee on Aging, final report. Ottawa, ON: Government of Canada.
Community Care and Assisted Living Act. (2002). Retrieved 14 April 2011 fromhttp://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_02075_01. Victoria, BC: Queen’s Printer.
Community Care and Assisted Living Regulation. (2008). Retrieved 30 April 2012 fromhttp://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/217_2004. Victoria, BC: Queen’s Printer.
Dhalla, I.A., Anderson, G.M., Mamdani, M.M., Bronskill, S.E., Sykora, K., & Rochon, P.A. (2002). Inappropriate prescribing before and after nursing home admission. Journal of the American Geriatrics Society, 50(6), 9951000.
Fick, D.M., Cooper, J.W., Wade, W.E., Waller, J.L., Maclean, J.R., & Beers, M.H. (2003). Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Archives of Internal Medicine, 163(22), 27162724.
Gaugler, J.E., Duval, S., Anderson, K.A., & Kane, R.L. (2007). Predicting nursing home admission in the U.S.: A meta-analysis. BMC Geriatrics, 7, 13.
Lum, J.M., Ruff, S., & Williams, A.P. (2005). When home is community: Community support services and the well-being of seniors in supportive and social housing. Toronto, ON: United Way of Greater Toronto. Retrieved 8 April 2013 fromhttp://www.teamgrant.ca/M-THAC%20Greatest%20Hits/M-THAC%20Projects/All%20info/When%20Home%20is%20Community/Publications/p400534.pdf.
McGrail, K.M., Evans, R.G., Barer, M.L., Kerluke, K.J., & McKendry, R. (2011). Diagnosing senescence: Contributions to physician expenditure increases in British Columbia, 1996/97 to 2005/06. Healthcare Policy, 7(1), 4154.
Miller, E.A., & Weissert, W.G. (2000). Predicting elderly people’s risk for nursing home placement, hospitalization, functional impairment, and mortality: A synthesis. Medical Care Research and Review, 57(3), 259297.
Mittelman, M.S., Haley, W.E., Clay, O.J., & Roth, D.L. (2006). Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease. Neurology, 67(9), 15921599.
Phillips, C.D., Munoz, Y., Sherman, M., Rose, M., Spector, W., & Hawes, C. (2003). Effects of facility characteristics on departures from assisted living: Results from a national study. The Gerontologist, 43(5), 690696.
Premier’s Council on Aging and Seniors’ Issues. (2006). Aging well in British Columbia. Victoria, BC: Premiers’ Council on Aging and Seniors’ Issues.
Ramroth, H., Specht-Leible, N., & Brenner, H. (2005). Hospitalisations before and after nursing home admission: A retrospective cohort study from Germany. Age and Ageing, 34(3), 291294.
Reid, R.J., Macwilliam, L., Verhulst, L., Roos, N., Atkinson, M., Care, M., et al. (2008). Performance of the ACG case-mix system in two Canadian provinces. Medical Care, 39(1), 8699.
Rochon, P.A., Normand, S-L., Gomes, T., Gill, S.S., Anderson, G.M., Melo, M., et al. (2008). Antipsychotic therapy and short-term serious events in older adults with dementia. Archives of Internal Medicine, 168(10), 10901096.
Rochon, P.A., Stukel, T.A., Bronskill, S.E., Gomes, T., Sykora, K., Wodchis, W.P., et al. (2007). Variation in nursing home antipsychotic prescribing rates. Archives of Internal Medicine, 167(7), 676683.
Shadish, W.R., William, R.S., Cook, T.D., & Campbell, D.T. (2001). Experimental and quasi-experimental designs for generalized causal inference. Boston: Wadsworth Publishing.
Stevenson, D.G., Decker, S.L., Dwyer, L.L., Huskamp, H.A., Grabowski, D.C., Metzger, E.D, et al. (2010). Antipsychotic and benzodiazepine use among nursing home residents: Findings from the 2004 National Nursing Home Survey. American Journal of Geriatric Psychiatry, 18(12), 10781092.
Wagner, A.K., Soumerai, S.B., Zhang, F., & Ross-Degnan, D. (2002). Segmented regression analysis of interrupted time series studies in medication use research. Journal of Clinical Pharmacy and Therapeutics, 27(4), 299309.
Wright, B. (2004). An overview of assisted living: 2004. Issue Brief. Washington, D.C.: American Association of Retired Persons Public Policy Institute.

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