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<p>Long-term care trajectories typically vary in care types, transitions and durations. Understanding these patterns can help optimize care provision. This study aimed at (1) identifying formal long-term care trajectories of severely disabled older individuals, and (2) assessing the relationships between individual characteristics and these trajectories.</p><p>Nationwide administrative data from the Centre for Care Needs Assessment were used. The sample included all 140,973 individuals older than 65 and with institutional care entitlements for somatic or psychogeriatric problems on July 1, 2015. The study period was from January 2010 to June 2019. Latent class growth analysis was performed to derive distinct care trajectories. Multinomial logistic regression analysis was used to examine the relationships between individual characteristics and these trajectories.</p><p>Five trajectories were identified, varying in complexity and duration of needs in long-term care. Two were characterized by mostly mild (somatic) institutional care and three by (psychogeriatric) institutional care with increasing duration and intensity. Men and younger individuals were more likely to require intensive (psychogeriatric) institutional care.</p><p>This study highlighted clear divergences among formal long-term care trajectories of severely disabled older individuals. Though less generous entitlement criteria may result in relatively lower expenditures in formal (institutional) care, they also imply increased use of alternatives, such as informal and community care. These insights can be used to tailor the provision of long-term care services in the future, and inform policy related to the financial sustainability of long-term care systems.</p>

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Trajectories of long-term care entitlements in severely disabled older adults using nationwide Dutch data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月23日

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  • France Portrait,
  • Yvonne Krabbe-Alkemade,
  • Trynke Hoekstra,
  • Kristina Thompson,
  • Hanna Rusticus

摘要

Long-term care trajectories typically vary in care types, transitions and durations. Understanding these patterns can help optimize care provision. This study aimed at (1) identifying formal long-term care trajectories of severely disabled older individuals, and (2) assessing the relationships between individual characteristics and these trajectories.

Nationwide administrative data from the Centre for Care Needs Assessment were used. The sample included all 140,973 individuals older than 65 and with institutional care entitlements for somatic or psychogeriatric problems on July 1, 2015. The study period was from January 2010 to June 2019. Latent class growth analysis was performed to derive distinct care trajectories. Multinomial logistic regression analysis was used to examine the relationships between individual characteristics and these trajectories.

Five trajectories were identified, varying in complexity and duration of needs in long-term care. Two were characterized by mostly mild (somatic) institutional care and three by (psychogeriatric) institutional care with increasing duration and intensity. Men and younger individuals were more likely to require intensive (psychogeriatric) institutional care.

This study highlighted clear divergences among formal long-term care trajectories of severely disabled older individuals. Though less generous entitlement criteria may result in relatively lower expenditures in formal (institutional) care, they also imply increased use of alternatives, such as informal and community care. These insights can be used to tailor the provision of long-term care services in the future, and inform policy related to the financial sustainability of long-term care systems.