Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods

Burton, Jennifer; Marwick, Charis; Galloway, James C.; Hall, Christopher; Nind, Thomas; Reynish, Emma; Guthrie, Bruce

doi:10.1093/ageing/afy137

Cited by 24 publications

(29 citation statements)

References 14 publications

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“…Further research is needed to explore the underlying reasons for this trend, and its implications for providing good quality end of life care to all LTCF residents. The inclusion of LTCF residents in nationally representative epidemiological studies, allowing for longitudinal analysis of characteristics prior to admission [54] and better identification of LTCF residents in existing routinely collected datasets [55], would greatly support research in this area.…”

Section: Implications For Future Research Policy and Practicementioning

confidence: 99%

Associations between Length of Stay in Long Term Care Facilities and End of Life Care. Analysis of the PACE Cross-Sectional Study

Moore

Payne

Keegan

et al. 2020

IJERPH

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Long term care facilities (LTCFs) are increasingly a place of care at end of life in Europe. Longer residence in an LTCF prior to death has been associated with higher indicators of end of life care; however, the relationship has not been fully explored. The purpose of this analysis is to explore associations between length of stay and end of life care. The analysis used data collected in the Palliative Care for Older People in care and nursing homes in Europe (PACE) study, a cross-sectional mortality follow-back survey of LTCF residents who died within a retrospective 3-month period, conducted in Belgium, England, Finland, Italy, the Netherlands and Poland. Primary outcomes were quality of care in the last month of life, comfort in the last week of life, contact with health services in the last month of life, presence of advance directives and consensus in care. Longer lengths of stay were associated with higher scores of quality of care in the last month of life and comfort in the last week of life. Longer stay residents were more likely to have advance directives in place and have a lasting power of attorney for personal welfare. Further research is needed to explore the underlying reasons for this trend, and how good quality end of life care can be provided to all LTCF residents.Ensuring LTCF residents approaching end of life receive appropriate care is challenging; residents may be frail, with multiple, complex care needs, and may be unable to either establish or communicate their preferences at end of life. Long term care facilities are often staffed by a combination of registered, qualified nurses and care assistants, who may have limited knowledge of end of life care for older adults and limited access to specialist services to support end of life care [7]. In addition, LTCF managers and their staff may lack clarity in defining and identifying end of life, or their role or responsibility in providing subsequent care within the facility [8]. In many European countries, end of life care in LTCFs in not well supported at a national level; in a review of 29 countries only eight had national policies which specifically addressed end of life care in LTCFs [9].Palliative care is defined as "an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual" [10]. The term "end of life care" is often used synonymously with palliative care in the UK, and refers to "an extended period of 1 to 2 years during which the patient/family and health professionals become aware of the life-limiting nature of their illness" [11]. Previous studies have found that the adoption of a palliative care approach in LTCFs led to a reduction in deaths outside the LTCF [12], an increase in the numbers of completed advance directives [13], improvements in end-of-life communication betw...

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Section: Implications For Future Research Policy and Practicementioning

confidence: 99%

Associations between Length of Stay in Long Term Care Facilities and End of Life Care. Analysis of the PACE Cross-Sectional Study

Moore

Payne

Keegan

et al. 2020

IJERPH

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“…Concerns over poor recording in administrative data have been highlighted in previous studies [ 21 , 22 ]. This has led to the development of methods to combat poor coding of care home residency [ 23 , 24 ].…”

Section: Limitationsmentioning

confidence: 99%

Do home modifications reduce care home admissions for older people? A matched control evaluation of the Care & Repair Cymru service in Wales

et al. 2020

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Background home advice and modification interventions aim to promote independent living for those living in the community, but quantitative evidence of their effectiveness is limited. Aim assess the risk of care home admissions for people with different frailty levels receiving home advice and modification interventions against a control group who do not. Study design and setting matched control evaluation using linked longitudinal data from the Secure Anonymised Information Linkage (SAIL) Databank, comprising people aged 60–95, registered with a SAIL contributing general practice. The intervention group received the Care & Repair Cymru (C & RC) service, a home advice and modification service available to residents in Wales. Methods frailty, age and gender were used in propensity score matching to assess the Hazard Ratio (HR) of care home admissions within a 1-, 3- and 5-year period for the intervention group (N = 93,863) compared to a matched control group (N = 93,863). Kaplan–Meier curves were used to investigate time to a care home admission. Results the intervention group had an increased risk of a care home admission at 1-, 3- and 5-years [HR (95%CI)] for those classified as fit [1-year: 2.02 (1.73, 2.36), 3-years: 1.87 (1.72, 2.04), 5-years: 1.99 (1.86, 2.13)] and mildly frail [1-year: 1.25 (1.09, 1.42), 3-years: 1.25 (1.17, 1.34), 5-years: 1.30 (1.23, 1.38)], but a reduced risk of care home admission for moderately [1-year: 0.66 (0.58, 0.75), 3-years: 0.75 (0.70, 0.80), 5-years: 0.83 (0.78, 0.88)] and severely frail individuals [1-year: 0.44 (0.37, 0.54), 3-years: 0.54 (0.49, 0.60), 5-years: 0.60(0.55, 0.66)]. Conclusions HRs indicated that the C & RC service helped to prevent care home admissions for moderately and severely frail individuals. The HRs generally increased with follow-up duration.

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“…The care home population is difficult to identify within UK routine data sources [19,20], thus the existence of a national data source offers significant potential. Making the SCHC linkable to other routine data sources provides opportunities to enhance the information collected within the census to help understand a difficult to research population [21].…”

Section: Strengthsmentioning

confidence: 99%

“…The SCHC data have been included as one of several care home data sources to ascertain care home admission as a clinical trial outcome. In this project, two randomised trial cohorts were linked to care home data sources to investigate the association between statin use and the need for institutional care [20]. The primary purpose of linking the SCHC data was to explore pathways into care from hospital, compared to those who move from the community.…”

Section: Usage To Datementioning

confidence: 99%

The Scottish Social Care Survey (SCS) and the Scottish Care Home Census (SCHC)

Henderson

Burton

Lynch

et al. 2019

IJPDS

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IntroductionLinked health care datasets have been used effectively in Scotland for some time. Use of social care data has been much more limited, partly because responsibility for these services is distributed across multiple local authorities. However, there are substantial interactions between health and social care (also known internationally as long-term care) services, and keen policy interest in better understanding these. We introduce two social care resources that can now be linked to health datasets at a population level across Scotland to study these interdependencies. These data emerge from the Scottish Government’s centralised collation of data from mandatory returns provided by local authorities and care homes. MethodsDeterministic and Probabilistic methods were used to match the Social Care Survey (SCS) and Scottish Care Home Census (SCHC) to the Community Health Index (CHI) number via the National Records of Scotland (NRS) Research Indexing Spine. ResultsFor the years 2010/11 to 2015/16, an overall match rate of 91.2% was achieved for the SCS to CHI from 31 of Scotland’s 32 local authority areas. This rate varied from 76.7% to 98.5% for local authority areas. A match rate of 89.8% to CHI was achieved for the SCHC in years 2012/13 to 2015/16 but only 52.5% for the years 2010/11 to 2011/12. ConclusionIndexing of the SCS and SCHC to CHI offers a new and rich resource of data for health and social care research.

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Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods

Cited by 24 publications

References 14 publications

Associations between Length of Stay in Long Term Care Facilities and End of Life Care. Analysis of the PACE Cross-Sectional Study

Associations between Length of Stay in Long Term Care Facilities and End of Life Care. Analysis of the PACE Cross-Sectional Study

Do home modifications reduce care home admissions for older people? A matched control evaluation of the Care & Repair Cymru service in Wales

The Scottish Social Care Survey (SCS) and the Scottish Care Home Census (SCHC)

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