Socio-economic predictors of time to care home admission in people living with dementia in Wales: A routine data linkage study

Int J Geriatr Psychiatry. 2021 Apr;36(4):511-520. doi: 10.1002/gps.5446. Epub 2020 Oct 19.

Abstract

Objectives: Limited research has shown that people with dementia (PwD) from lower socio-economic backgrounds can face difficulties in accessing the right care at the right time. This study examined whether socio-economic status (SES) and rural versus urban living location are associated with the time between diagnosis and care home admission in PwD living in Wales, UK.

Methods/design: This study linked routine health data and an e-cohort of PwD who have been admitted into a care home between 2000 and 2018 living in Wales. Survival analysis explored the effects of SES, living location, living situation, and frailty on the time between diagnosis and care home admission.

Results: In 34,514 PwD, the average time between diagnosis and care home admission was 1.5 (±1.4) years. Cox regression analysis showed that increased age, living alone, frailty, and living in less disadvantaged neighbourhoods were associated with faster rate to care home admission. Living in rural regions predicted a slower rate until care home admission.

Conclusions: This is one of the first studies to show a link between socio-economic factors on time to care home admission in dementia. Future research needs to address variations in care needs between PwD from different socio-economic and geographical backgrounds.

Keywords: care homes; dementia; health inequalities; routine data; socio-economic status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Dementia*
  • Hospitalization
  • Humans
  • Information Storage and Retrieval
  • Wales / epidemiology