Differences in Nursing Home Admission Between Functionally Defined Populations in Germany and the Association with Quality of Health Care

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2021 Mar 3

PMID 33653333

Citations 2

Authors

Dominik Domhoff

Kathrin Seibert

Susanne Stiefler

Karin Wolf-Ostermann

Dirk Peschke

Affiliations

Soon will be listed here.

Abstract

Background: People prefer to age in place and not move into a nursing home as long as possible. The prevention of cognitive and functional impairments is feasible to support this goal. Health services play a key role in providing support for underlying medical conditions. We examined differentials in nursing home admissions between patient sharing networks in Germany and whether potential variations can be attributed to indicators of health care provision.

Methods: We conducted an ecological study using data of patients of 65 years and above from all 11 AOK statutory health insurance companies in Germany. Nursing home admissions were observed in a cohort of persons becoming initially care-dependent in 2006 (n = 118,213) with a follow-up of up to 10 years. A patient sharing network was constructed and indicators for quality of health care were calculated based on data of up to 6.6 million patients per year. Community detection was applied to gain distinct patient populations. Analyses were conducted descriptively and through regression analyses to identify the variation explained by included quality indicators.

Results: The difference in the proportion of nursing home admissions between identified clusters shows an interquartile range (IQR) of 12.6% and the average time between onset of care-dependency and admission to a nursing home an IQR of 10,4 quarters. Included quality indicators attributed for 40% of these variations for the proportion of nursing home admissions and 49% for the time until nursing home admission, respectively. Indicators of process quality showed the single highest contribution. Effects of single indicators were inconclusive.

Conclusions: Health services can support persons in their preference to age in place. Research and discussion on adequate health care for care-dependent persons and on conditions, where nursing home admission may be beneficial, is necessary.

Citing Articles

Data linkage of German statutory health insurance claims data and care needs assessments preceding a population-based cohort study on nursing home admission.

Domhoff D, Seibert K, Stiefler S, Wolf-Ostermann K, Peschke D BMJ Open. 2022; 12(6):e063475.

PMID: 35772817 PMC: 9247689. DOI: 10.1136/bmjopen-2022-063475.

The influence of primary care quality on nursing home admissions in a multimorbid population with and without dementia in Germany: a retrospective cohort study using health insurance claims data.

Seibert K, Stiefler S, Domhoff D, Wolf-Ostermann K, Peschke D BMC Geriatr. 2022; 22(1):52.

PMID: 35030993 PMC: 8759199. DOI: 10.1186/s12877-021-02731-8.

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