Is ageing-in-place an alternative for nursing home admission? A comparison of the survival, days in care and costs of older individuals

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Abstract

Background & objectives Long-term care (LTC) expenses for older individuals are rising rapidly in almost all high-income countries. In an attempt to slow the growth of LTC costs, governmental policy focusses increasingly on ageing-in-place to prevent expensive nursing home admissions. Ageing-in-place is often what individuals prefer. Following this trend, the “complete in-home package” (VPT) became available in 2015 in the Netherlands. This package allows clients to receive nursing home care within their own environment. This study compares the survival, days in care and costs of older individuals who use VPT-care or institutional care. Methods Data from two healthcare providers covering the period between January 2016 and August 2020 were used. The study sample included 2,136 clients, of whom 559 received VPT care. Information on survival, days in care, costs as well as other individual (health) characteristics was available. Survival analyses techniques were used. Results After correction for differences in individual (health) characteristics across the care groups, our study shows that VPT clients on average live longer than those in institutions and that especially clients with lower LTC entitlement benefit from VPT care. VPT clients were observed to spend 366 days longer in care and the average daily costs of VPT care was €58 lower than those of institutional care. Discussion/Conclusion Our study provides preliminary results on longer survival outcomes and lower costs for VPT clients compared to those in institutions. In the absence of random allocation, future research should investigate differences in quality of life and include additional health-related factors in the analyses on mortality. Finally, to investigate the LTC costs more in depth, an elaborate economic evaluation is recommended. If VPT care turns out to be an appropriate alternative for institutional care based on a combination of costs, health and QoL outcomes, it should be offered in the future on a larger scale.
Original languageEnglish
Number of pages15
Publication statusUnpublished - 1 May 2021

Keywords

  • Long-term care
  • ageing in place

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