Survival rates among older care home residents are lower than for older people in the community because care home residents are typically in poorer health than community-dwelling people of the same age. The policy emphasis on enabling older people to remain in their own homes means that care home entry may be occurring at later ages than previously. Whether this is resulting in more disparity between the survival rates of care home residents and older people living in the community is unknown; previous studies examined only single cohorts of older people. How survival in care homes is changing is relevant for health and social care planning. We will calculate the proportion of care home residents aged 65+ observed in each year since 1995 who are alive 6 months, 1 year and 2 years later. We will contrast these proportions with those for older people living in the community. We will take account of differences across years and between care home residents and community-dwelling older people in their ages, gender and the degree of deprivation where they live. This will give insights into trends in survival amongst the two population groups and suggest avenues for further research to explain these trends.
Policy emphasis on enabling older people to remain in their own homes means that care home entry may be occurring at later ages. Whether this is resulting in more disparity between survival of care home residents and those living in the community is unknown; previous studies examined only single cohorts. How survival in care homes is changing is relevant for health and social care planning. Objective: To examine trends since 1995 in 6-month, 1-year and 2-year survival of older care home residents in England, compared with community-dwelling older people, adjusting for age, gender and patient level index of multiple deprivation. Methods: For each year from 1995, patients in CPRD aged 65+ will be classified as care home residents or community dwelling using GP recorded events. Their 6-month, 1-year and 2-year survival will be determined from linked ONS mortality register data. Data analysis: Unadjusted (other than for time period) and adjusted Cox proportional hazard and logistic regression models of survival will be estimated for care home residents and community dwelling people separately; and for the two groups combined, entering care home residence as a co-variate (testing for significant interactions with age, gender and deprivation).
Unadjusted 6-month, 1-year and 2-year survival rates for each year from 1995 to 2015 among care home residents aged 65 and over (GP patients aged 65+ and with a record of care home residence in the earlier of each pair of time points);Trends over the same periods in 6-month, 1-year and 2- year survival, adjusting for age, gender and patient level index of multiple deprivation of care home residents aged 65+ compared with community-dwelling people aged 65+ (GP patients aged 65+ and with no record of residence in care home in the earlier of each pair of time points).
Ruth Hancock - Chief Investigator - University of East Anglia
Ferran Espuny Pujol - Corresponding Applicant - University College London ( UCL )
Marcello Morciano - Collaborator - University of East Anglia
ONS Death Registration Data;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Patient Level Index of Multiple Deprivation