Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-10T11:59:42.721Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors Associated with Residential Long-Term Care Wait-List Placement in North West Ontario*

Published online by Cambridge University Press:  06 July 2017

Audrey Laporte ,
Adrian Rohit Dass ,
Kerry Kuluski ,
Allie Peckham ,
Whitney Berta ,
Janet Lum  and
A. Paul Williams
Audrey Laporte*
Affiliation:
Institute of Health Policy, Management, and Evaluation and Canadian Centre for Health Economics, University of Toronto
Adrian Rohit Dass
Affiliation:
Institute of Health Policy, Management, and Evaluation and Canadian Centre for Health Economics, University of Toronto
Kerry Kuluski
Affiliation:
Institute of Health Policy, Management, and Evaluation, University of Toronto
Allie Peckham
Affiliation:
Institute of Health Policy, Management, and Evaluation, University of Toronto
Whitney Berta
Affiliation:
Institute of Health Policy, Management, and Evaluation, University of Toronto
Janet Lum
Affiliation:
Department of Politics and Public Administration, Ryerson University
A. Paul Williams
Affiliation:
Institute of Health Policy, Management, and Evaluation, University of Toronto
*
†La correspondance et les demandes de tire-à-part doivent être adressées à : / Correspondence and requests for offprints should be sent to: Audrey Laporte, Ph.D. Associate Professor Institute of Health Policy, Management and Evaluation Health Sciences Building, University of Toronto 155 College Street, 4th floor Toronto, ON, M5T 3M6 <audrey.laporte@utoronto.ca>
Get access Rights & Permissions [Opens in a new window]

Abstract

This article is based on a study that investigated factors associated with long-term care wait list placement in Ontario, Canada. We based the study’s analysis on Resident Assessment Instrument for Home Care (RAI-HC) data for 2014 in the North West Local Health Integration Network (LHIN). Our analysis quantified the contribution of three factors on the likelihood of wait list placement: (1) care recipient, (2) informal caregiver, and (3) formal system. We find that all three factors are significantly related to wait list placement. The results of this analysis could have implications for policies aimed at reducing the number of wait-listed individuals in the community.

Résumé

Cet article examine les facteurs associés à l’inscription sur une liste d’attente pour une place en établissements de soins de longue durée en Ontario (Canada). L’analyse a été réalisée à partir de données collectées avec l’Instrument d’évaluation des résidents - Services à domicile (RAI-HC) dans le Réseau local d’intégration des services de santé du Nord-Ouest (RLISS) en 2014. Notre analyse quantifie l’influence de facteurs associés aux bénéficiaires de soins, aux aidants naturels et aux établissements de soins sur la probabilité d’inscription sur une liste d’attente. Nous observons que ces trois facteurs sont significativement reliés à l’inscription sur une telle liste. Les résultats de cette analyse pourraient avoir une incidence sur les politiques visant à réduire le nombre d’individus vivant dans la communauté qui sont inscrits sur une liste d’attente pour des établissements de soins de longue durée.

Keywords

aginginformal carecaregiversinstitutional long-term careaging at homehome carevieillissementsoins informelssoignantssoins de longue durée institutionnalisésvieillir chez soisoins à domicile
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 36 , Issue 3 , September 2017 , pp. 286 - 305
Check for updates
Copyright
Copyright © Canadian Association on Gerontology 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This study was supported by the Ontario Ministry of Health and Long-Term Care Health System Performance Research Network (HSPRN, Grant # 06034). The views expressed in this article are the views of the authors and do not necessarily reflect those of the funders.

References

Andel, R., Hyer, K., & Slack, A. (2007). Risk factors for nursing home placement in older adults with and without dementia. Journal of Aging and Health, 19, 213–228.Google Scholar
Averett, S. L., Sikora, A., & Argys, L. M. (2014). Intergenerational transfers and caregiving within families. In Redmount, E. (Ed.), The economics of the family: How the household affects markets and economic growth (pp. 93–128). Santa Barbara, CA: Praeger. Google Scholar
Auditor General of Ontario. (2012). 2012 annual report of the Office of the Auditor General of Ontario. Chapter 3 Section 3.08: Long-term-care home placement process. Retrieved from http://www.auditor.on.ca/en/content/annualreports/arreports/en12/308en12.pdf Google Scholar
Boaz, R., & Muller, C. (1994). Predicting the risk of permanent nursing home residence: The role of community help as indicated by family helpers and prior living arrangements. Health Services Research, 29, 391–414.Google Scholar
Bolin, J., Phillips, C., & Hawes, C. (2006). Differences between newly admitted nursing home residents in rural and nonrural areas in a national sample. Gerontologist, 46, 33–41.Google Scholar
Boyd, M., Bowman, C., Broad, J. B., & Connolly, M. J. (2012). International comparisons of long-term care resident dependency across four countries (1998–2009): A descriptive study. Australian Journal of Aging, 31, 233–240.Google Scholar
Branch, L., & Jette, A. (1982). A prospective study of long-term care institutionalization among the aged. American Journal of Public Health, 72, 1373–1379.Google Scholar
Canadian Healthcare Association. (2009). Home care in Canada: From the margins to the mainstream. Ottawa, ON: Author. Retrieved from http://www.healthcarecan.ca/wp-content/uploads/2012/11/Home_Care_in_Canada_From_the_Margins_to_the_Mainstream_web.pdf Google Scholar
Canadian Institute for Health Information (CIHI). (2002). RAI-Home care (RAI-HC) manual. Canadian Version. 2nd ed. Retrieved from https://secure.cihi.ca/estore/productSeries.htm?pc=PCC130 Google Scholar
Challis, D., & Hughes, J. (2002). Frail old people at the margins of care: Some recent research findings. British Journal of Psychiatry, 180, 126–130.CrossRefGoogle ScholarPubMed
Challis, D., Hughes, J., McNiven, F., Stewart, K., & Darton, R. (1999). Estimating the balance of care. Personal Social Services Research Unit, P47. Retrieved from http://www.pssru.ac.uk/pdf/p047.pdf Google Scholar
Chan, L., Hart, G., & Goodman, D. (2006). Care management, dementia care and specialist mental health services: An evaluation. International Journal of Geriatric Psychiatry, 17, 140–146.Google Scholar
Charles, K., & Sevak, P. (2005). Can family caregiving substitute for nursing home care? Journal of Health Economics, 24, 1174–1190.Google Scholar
Clarkson, P., Hughes, J., & Challis, D. (2005). The potential impact of changes in public funding for residential and nursing-home care in the United Kingdom: The residential allowance. Ageing & Society, 25, 159–180.CrossRefGoogle Scholar
Connolly, S., & O’Reilly, D. (2009). Variation in care home admissions across areas of Northern Ireland. Age and Ageing, 38, 461–465.CrossRefGoogle ScholarPubMed
Coward, R., Netzer, J., & Mullens, R. (1996). Residential differences in the incidence of nursing home admissions across a six-year period. The Journals of Gerontology Series B: Psychological Science and Social Sciences, 51, S258–S267.Google Scholar
Donner, G. (2015). Bringing care home. Report of the Expert Group on Home & Community Care. Retrieved from http://health.gov.on.ca/en/public/programs/ccac/docs/hcc_report.pdf Google Scholar
Drummond, D. (2012). Public services for Ontarians: A path to sustainability and excellence. Prepared for Commission on the Reform of Ontario’s Public Services, Ontario Ministry of Finance. Toronto, ON: Queen’s Printer for Ontario. Retrieved from http://www.fin.gov.on.ca/en/reformcommission/ Google Scholar
Foley, D., Ostfeld, A., Branch, L., Wallace, R., McGloin, J., & Cornoni-Huntley, J. (1992). The risk of nursing home admission in three communities. Journal of Aging and Health, 4, 155–173.Google Scholar
Gaugler, J., Duval, S., Anderson, K., & Kane, R. (2007). Predicting nursing home admission in the US: A meta-analysis. BMC Geriatrics, 7, 1–14.Google Scholar
Gaugler, J., Yu, F., Krichbaum, K., & Wyman, J. (2009). Predictors of nursing home admission for persons with dementia. Medical Care, 47, 191–198.CrossRefGoogle ScholarPubMed
Greene, W. H. (2012). Econometric analysis (7th ed.). Upper Saddle River, NJ: Prentice Hall.Google Scholar
Health Quality Ontario. (2012). Quality monitor: 2012 report on Ontario’s health system. Toronto, ON: Author. Retrieved from http://www.hqontario.ca/portals/0/documents/pr/qmonitor-full-report-2012-en.pdf Google Scholar
Hermus, G., Stonebridge, C., Thériault, L., & Bounajm, F. (2012). Home and community care in Canada: An economic footprint. Retrieved from the Conference Board of Canada website: http://www.conferenceboard.ca/e-library/abstract.aspx?did=4841 Google Scholar
Hirdes, J. P., Poss, J. W., & Curtin-Telegdi, N. (2008). The method for assigning priority levels (MAPLe): A new decision-support system for allocating home care resources. BMC Medicine, 6.Google Scholar
Hollander, M. J., Liu, G., & Chappell, N. (2009). Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to the elderly. Healthcare Quarterly, 12, 42–9.Google Scholar
Hughes, J., & Challis, D. (2004). Frail older people-margins of care. Reviews in Clinical Gerontology, 14, 155–164.Google Scholar
InterRAI, . (2015). InterRAI instruments worldwide. Retrieved from http://www.interrai.org/worldwide.html Google Scholar
Jette, A., Tennstedt, S., & Crawford, S. (1995). How does formal and informal community care affect nursing home use? The Journals of Gerontology B: Psychological Science and Social Sciences, 50, S4–S12.Google Scholar
Katz, S., & Stroud, M. W. (1989). Functional assessment in geriatrics. Journal of the American Geriatric Society, 37, 267–271.Google Scholar
Keating, N., & Phillips, J. (2008). A critical human ecology perspective on rural ageing. In Keating, N. (Ed.), Rural ageing: A good place to grow old? (pp. 1–10). Bristol, ENG: Policy Press.Google Scholar
Kim, E. Y., Cho, E., & Lee, N. J. (2013). Effects of family caregivers on the use of formal long-term care in South Korea. International nursing review, 60, 520–527.Google Scholar
Kralj, B. (2009). Measuring rurality-RIO 2008_BASIC: Methodology and results. Toronto, ON: Ontario Medical Association Economics Department. Retrieved from https://www.oma.org/wp-content/uploads/2008rio-fulltechnicalpaper.pdf Google Scholar
Kuluski, K., Williams, A. P., Berta, W., & Laporte, A. (2012). Home care or long-term care? Setting the balance of care in urban and rural Northwestern Ontario, Canada. Health and Social Care in the Community, 20, 438–448.CrossRefGoogle ScholarPubMed
Kuluski, K., Williams, A. P., Laporte, A., & Berta, W. (2012). The role of community based care capacity in shaping risk of long-term care facility placement. Healthcare Policy, 8, 92–105.Google Scholar
Laporte, A., Croxford, R., & Coyte, P. (2007). Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status? A Canadian experience. Health and Social Care in the Community, 15, 108–119.Google Scholar
Lum, J., Williams, A. P., Sladek, J., & Ying, A. (2010). Balancing care for supportive housing: Final report. Toronto, ON: Author. Retrieved from http://www.ryerson.ca/content/dam/crncc/knowledge/relatedreports/balancecare/Balancing%20Care%20for%20Supportive%20Housing%20Final%20Report.pdf Google Scholar
Luppa, M., Luck, T., Matschinger, H., König, H., & Riedel-Heller, S. (2010). Predictors of nursing home admission of individuals without a dementia diagnosis before admission – results from the Leipzig Longitudinal Study of the Aged (LEILA 75+). BMC Health Services Research, 10, 186–194.Google Scholar
Luppa, M., Luck, T., Weyerer, S., König, H., Brähler, E., & Riedel-Heller, S. (2010). Prediction of institutionalization in the elderly. A systematic review. Age and Ageing, 39(1), 31–38.Google Scholar
Maxwell, C. J., Soo, A., Hogan, D. B., Wodchis, W. P., Gilbart, E., Amuah, J., … Strain, L. A. (2013). Predictors of nursing home placement from assisted living settings in Canada. Canadian Journal on Aging/La Revue canadienne du vieillissement, 32(4), 333–348.Google Scholar
McFall, S., & Miller, B. (1992). Caregiver burden and nursing home admission of frail elderly persons. Journal of Gerontology, 47, S73–S79.Google Scholar
McKinlay, J., Crawford, S., & Tennstedt, S. (1995). The everyday impacts of providing informal care to dependent elders and their consequences for the care recipients. Journal of Aging and Health, 7, 497–528.Google Scholar
McNeil, C., & Hunter, J. (2014). The generation strain: Collective solutions to care in an ageing society. London, ON: Institute for Public Policy Research. Retrieved from http://www.ippr.org/files/publications/pdf/generation-strain_Apr2014.pdf?noredirect=1 Google Scholar
Mestheneos, E. (2011). Ageing in place in the European Union. Global Ageing, 7(2), 17–24. Retrieved from the International Federation on Ageing website: http://www.ifa-fiv.org/wp-content/uploads/global-ageing/7.2/7.2.mestheneos.pdf Google Scholar
Miller, E. A., & Weissert, W. G. (2000). Predicting elderly people’s risk for nursing home placement, hospitalization, functional impairment, and mortality: A synthesis. Medical Decision Making, 20, 332–342.Google Scholar
Ministry of Health and Long Term Care (MOHLTC). (2006). CCAC home care services. In Community Care Access Centres client services policy manual (Chapter 7). Retrieved from http://www.health.gov.on.ca/english/providers/pub/manuals/ccac/ccac_7.pdf Google Scholar
Ministry of Health and Long-Term Care. (2011). Assisted living services for high risk seniors policy. Retrieved from http://www.centrallhin.on.ca/goalsandachievements/seniors/∼/media/sites/central/uploadedfiles/Public_Community/Advancing_Quality/Revised%202012%20AL%20policy%20.pdf Google Scholar
Ministry of Health and Long-Term Care. (2012). Health Analyst’s Toolkit. Health Analytics Branch. Retrieved from http://www.health.gov.on.ca/english/providers/pub/healthanalytics/health_toolkit/health_toolkit.pdf Google Scholar
Ministry of Health and Long Term Care. (2015a). Community care access centres [Public information]. Retrieved from http://www.health.gov.on.ca/en/public/contact/ccac/ Google Scholar
Ministry of Health and Long Term Care. (2015b). Ontario investing $44 million in home and community care [News release]. Retrieved from http://news.ontario.ca/mohltc/en/2015/03/ontario-investing-44-million-in-home-and-community-care.html Google Scholar
Morris, J. N., Fries, B. E., Mehr, D. R., Hawes, C., Phillips, C., Mor, V., & Lipsitz, L. A. (1994). MDS cognitive performance scale©. Journal of Gerontology, 49(4), M174–M182.Google Scholar
Morris, J. N., Fries, B. E., & Morris, S. A. (1999). Scaling ADLs within the MDS. Journal of Gerontology: Medical Sciences, 54, M546–M553.Google Scholar
Newman, S., Struyk, R., Wright, P., & Rice, M. (1990). Overwhelming odds: Caregiving and the risk of institutionalization. Journal of Gerontology, 45, S173–S183.Google Scholar
North West Local Health Integration Network (NW LHIN). (2013). Population health profile. Thunder Bay. Retrieved from http://www.northwestlhin.on.ca/∼/media/sites/nw/reports/Population%20Health%20Profiles/Population%20Report%202013%20English.pdf Google Scholar
O’Brien, R. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity, 41, 673–690.Google Scholar
Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS). (2015). Provincial long term care snapshot January 2015. Retrieved from https://www.middlesex.ca/council/2015/march/10/C%2015%20-%20CW%20Info%20-%20March%2010%20-%20OANHSS-LTC-SnapshotJanuary2015.pdf Google Scholar
Ontario Seniors’ Secretariat. (2013). Independence, activity and good health: Ontario’s action plan for seniors. Toronto, ON: Queen’s Printer for Ontario. Retrieved from https://dr6j45jk9xcmk.cloudfront.net/documents/215/ontarioseniorsactionplan-en-20130204.pdf Google Scholar
Organization for Economic Cooperation and Development (OECD). (2011). Help wanted? Providing and paying for long-term care. Retrieved from http://www.oecd.org/els/health-systems/47836116.pdf Google Scholar
Pearlman, D., & Crown, W. (1992). Alternative sources of social support and their impacts on institutional risk. The Gerontologist, 32, 527–535.Google Scholar
Peckham, A., Williams, A. P., & Neysmith, S. (2014). Balancing formal and informal care for older persons: How case managers respond. Canadian Journal on Aging/La Revue canadienne du vieillissement, 33(2), 123–136.Google Scholar
Ray-Mukherjee, J., Nimon, K., Mukherjee, S., Morris, D. W., Slotow, R., & Hamer, M. (2014). Using commonality analysis in multiple regressions: A tool to decompose regression effects in the face of multicollinearity. Methods in Ecology and Evolution, 5, 320–328.Google Scholar
Rosenthal, T., & Fox, C. (2000). Access to health care for the rural elderly. The Journal of the American Medical Association, 284, 2034–2036.Google Scholar
Schulz, E. (2014). Impact of ageing on long-term care workforce in Denmark [Supplement A to NEUJOBS working paper D12.2.] Retrieved from http://www.neujobs.eu/sites/default/files/publication/2014/02/NEUJOBS%20Working%20Paper-D12.2-Denmark-2.pdf Google Scholar
Seibold, D. R., & McPhee, R. D. (1979). Human Communication Research, 5, 355–365.Google Scholar
Sims-Gould, J., Martin Matthews, A., & Keating, N. (2008). Distance, privacy and independence rural homecare. In Keating, N. (Ed.), Rural ageing: A good place to grow old? (pp. 43–51). Bristol, ENG: Policy Press.Google Scholar
Sinha, S. K. (2012). Living longer, living well. Report submitted to the Minister of Health and Long-Term Care. Retrieved from http://www.ontla.on.ca/library/repository/mon/27003/321430.pdf Google Scholar
Sinha, S. K. (2013). Living longer, living well highlights and key recommendations from the report submitted to the minister of health and long-term care and the minister responsible for seniors on recommendations to inform a seniors strategy for Ontario. Retrieved from http://www.ontla.on.ca/library/repository/mon/27001/320539.pdf Google Scholar
Spillman, B., & Long, S. (2009). Does high caregiver stress predict nursing home entry? Inquiry: The Journal of Health Care Organization, Provision, and Financing, 46, 140–161.Google Scholar
St. John, P. D., Montgomery, P. R., Kristjansson, B., & McDowell, I. (2002). Cognitive scores, even within the normal range, predict death and institutionalization. Age and Ageing, 31, 373–378.Google Scholar
Stabile, M., Laporte, A., & Coyte, P. C. (2006). Household responses to public home care programs. Journal of Health Economics, 25, 674–701.Google Scholar
Studenmund, A. H. (2006). Using econometrics: A practical guide (5th ed.). New York, NY: Addison Wesley.Google Scholar
Tomiak, M., Berthelot, J., Guimond, E., & Mustard, C. (2000). Factors associated with nursing-home entry for elders in Manitoba, Canada. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55, M279–M287.Google Scholar
Tucker, S., Hughes, J., Burns, A., & Challis, D. (2008). The balance of care: Reconfiguring services for older people with mental health problems. Aging & Mental Health, 12, 81–91.Google Scholar
Van Houtven, C., & Norton, E. (2004). Informal care and health care use of older adults. Journal of Health Economics, 23, 1159–1180.Google Scholar
Walker, D. (2011). Caring for our aging population and addressing alternate level of care: Report submitted to the minister of health and long-term care. Toronto, ON: Ontario Ministry of Health and Long-Term Care. Retrieved from http://www.ontla.on.ca/library/repository/mon/25009/312292.pdf Google Scholar
Williams, A. P., Challis, D., Deber, R., Watkins, J., Kuluski, K., Lum, J. M., & Daub, S. (2009). Balancing institutional and community-based care: Why some older persons can age successfully at home while others require residential long-term care. Healthcare Quarterly, 12, 95–105.Google Scholar
Williams, A. P., Watkins, J., & Kuluski, K. (2010). The North West balance of care project II: Final report. Report submitted to the North West Community Care Access Centre and North West Local Health Integration Network. Retrieved from http://www.ryerson.ca/content/dam/crncc/knowledge/relatedreports/balancecare/NWBoCIIReportSupportiveHousing.pdf Google Scholar
Williams, A. P., Kuluski, K., Watkins, J., Montgomery, R., Lum, J. M., Ying, A., & Challis, D. (2009). The balance of care. Canadian Research Network for Care in the Community In-Focus Fact Sheet. Retrieved from http://www.ryerson.ca/content/dam/crncc/knowledge/infocus/factsheets/InFocusBoCNovember2009FINAL.pdf Google Scholar
Supplementary material: File

Laporte supplementary material

Laporte supplementary material 1

Download Laporte supplementary material(File)
File 13.1 KB
Supplementary material: File

Laporte supplementary material

Laporte supplementary material 2

Download Laporte supplementary material(File)
File 12.5 KB