Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 12
Impact of changes in length of stay on the demand for residential care services in England: estimates from a dynamic microsimulation model
- Authors:
- FERNANDEZ Jose-Luis, FORDER Julien
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2011
- Pagination:
- 13p.
- Place of publication:
- Canterbury
Residential care services constitute the largest component (approximately 60%) of social care expenditure in England. Understanding the level of demand for residential care services in the future, and the associated costs, is paramount to planning for an efficient and equitable social care system. This paper explores the impact of changes in the length of time that individuals spend in residential care once admitted, in order to gauge the impact of likely improvements in the survival of residents in the future. This analysis uses a dynamic microsimulation model to estimates future changes in demand and levels of use of residential care services in England. The central assumptions of the model include a constant age and gender specific prevalence of disability, gains in life expectancy, and real-terms increases in unit costs. Care home unit costs are assumed to start at £550 per week on average and grow by 1.5% until 2016/7 and by 2% thereafter. The implications of length of stay and costs are made in terms of their impact on the projected level of funding required to support future numbers of older people with care needs. The analysis highlights how relatively modest changes in survival in residential care will lead a higher levels of demand and expenditure. It also shows the significant impact of changes in the growth of the weekly person costs of care home services.
Projections of demand for residential care for older people in England: report for BUPA
- Authors:
- KING Derek, et al
- Publisher:
- Personal Social Services Research Unit
- Publication year:
- 2010
- Pagination:
- 23p., bibliog.
- Place of publication:
- Canterbury
This paper reports on the impact that changes in assumptions about household composition, housing tenure and the balance of domiciliary to institutional care could have on the future numbers of older people in care homes. It uses the PSSRU model, a macrosimulation model which makes projections of demand for long-term care for older people. A series of scenarios regarding changes in household composition, tenure, and balance of care were developed for this project, and their impact compared to that of scenarios previously investigated about variant population projections, marital status and rises in the real costs of care. The results show the impact of the scenarios in terms of the distribution between public and privately funded residents in care homes, projected numbers of recipients of local authority funded home care, total expenditure on long-term care and workforce requirements for care homes. The analyses suggest that projections of future demand for residential care are very sensitive to assumptions regarding the rate of change in the probability of entering residential care. This is also likely to impact significantly on the distribution of funding of residential care between public versus private spending. The rate of change in the probability of entering residential care is also likely to have a significant impact on the future demand for workers employed in care homes.
Analysis of recurrent events: a systematic review of randomised controlled trials of interventions to prevent falls
- Authors:
- DONALDSON Meghan G., et al
- Journal article citation:
- Age and Ageing, 38(2), March 2009, pp.151-155.
- Publisher:
- Oxford University Press
The use of appropriate methods for analysing recurrent events is important in randomised controlled trials of fall prevention interventions. This review identified 83 RCTs published between 1994 and November 2006, and determined the proportion using the following methods: negative binomial regression; the Andersen-Gill extension of the Cox proportional hazards model; and the WLW (Wei, Lin and Weissfield) marginal model. Fewer than a third of the papers used one of these methods, and fewer than 15% used the mean cumulative function to represent falls data graphically. The authors recommend that researchers and clinicians in the field should consult statisticians with expertise in recurrent event methodology, and that guidance should be developed by bodies such as CONSORT.
Demand for long term care for older people in England to 2031
- Authors:
- WITTENBERG Raphael, et al
- Journal article citation:
- Health Statistics Quarterly, 12, Winter 2001, pp.5-17.
- Publisher:
- Office for National Statistics
How best to finance long-term care has been the subject of considerable recent debate. One reason is that the numbers of people in England aged 65 and over are projected to increase by 60 percent over the next 35 years. The Personal Social Services Research Unit (PSSRU) has developed a model to make projections of demand for long-term care for older people, to 2031. This article outlines the methodology and results of the model. PSSRU projections suggest that, under central assumptions, long term care expenditure will need to rise by around 150 percent in real terms over the next 30 years to meet demand.
The probability of nursing home use over a lifetime in Australia
- Author:
- LIU Zhibin
- Journal article citation:
- International Journal of Social Welfare, 9(3), July 2000, pp.169-180.
- Publisher:
- Wiley
This article further develops the life table models used in the USA by taking advantage of the superior data available in Australia. The probabilities of nursing home use over a lifetime are estimated for various ages for men and women. The results show that over one-third of the members of a female birth cohort will eventually enter nursing homes for long-term care at least once. The corresponding probability for males is one in five. A woman at age 65 faces a probability as high as 39% of using a nursing home for permanent care before her death compared with 25% for a man at age 65.
Risk factors of falls in community-dwelling older adults: logistic regression tree analysis
- Authors:
- YAMASHITA Takashi, NOE Douglas A., BAILER A. John
- Journal article citation:
- Gerontologist, 52(6), December 2012, pp.822-832.
- Publisher:
- Oxford University Press
The authors applied a novel logistic regression tree-based method to identify fall risk factors and possible interactions among them. A nationally representative sample of American adults aged 65 years and over (n = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used. Logistic Tree with Unbiased Selection, a computer algorithm for tree-based modelling, recursively split the entire group in the data set into mutually exclusive subgroups and fitted a logistic regression model in each subgroup to generate a tree diagram. Older adults with; a fall history, no activities of daily living (ADL) limitation, at least one instrumental activity of daily living limitation, or fall histories and at least one ADL limitation were at highest risk of falls. The best predictor of falls varied within each subgroup. The authors conclude that the use of tree-based methods may provide useful information for intervention program design and resource allocation targeting subpopulations of older adults at risk of falls.
Predicting social care costs: a feasibility study
- Authors:
- BARDSLEY Martin, et al
- Publisher:
- Nuffield Trust
- Publication year:
- 2011
- Pagination:
- 81p.
- Place of publication:
- London
This report describes a study that explored whether statistical models can be used to predict an individual person’s future need for intensive social care in the UK. The aim of the project was to obtain pseudonymous individual-level data from several primary care, secondary care and social care organisations; link collate and analyse these data at the individual level; and attempt to develop a statistical model to predict which individuals are at greatest risk of requiring intensive social care in the 12 months after prediction. Data was provided by 4 Primary Care Trusts (PCTs) and one care trust. The research shows how it is possible to link routine data from health and social care information systems in a way that protects individuals’ identities. The project showed that it is possible to construct predictive models for social care. How these models might fit into everyday working practice now needs investigating. The predictive accuracy of the models was comparable to some of the models used by the NHS to predict hospital admissions. The authors comment that linked person-level information has the potential to improve quality of care services, whether through improved identification of high-risk individuals, comparative performance measures, service evaluations or budget-setting. There is a need to ensure that the quality of information about social care services improves comparably to the recent improvement seen in the quality of data about individual health care use.
Comparison of methods for analyzing longitudinal binary outcomes: cognitive status as an example
- Authors:
- KUCHIBHATLA M., FILLENBAUM G. G.
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.403-408.
- Publisher:
- Taylor and Francis
Longitudinal data generate correlated observations. Ignoring correlation can lead to incorrect estimation of standard errors, resulting in incorrect inferences of parameters. In the example used here, standard logistic regression, a population-averaged (PA) model fit using generalized estimating equations (GEE), and random-intercept models are used to model binary outcomes at baseline, three and six years later. The outcomes indicate cognitive impairment versus no cognitive impairment in a sample of community dwelling elders. The models include both time-invariant (age, gender) and time-varying (time, interactions with time) covariates. The absolute estimates from random-intercept models are larger than those of both standard logistic and GEE models. Compared to the model fit using GEE that accounts for time dependency, standard logistic regression models overestimate standard errors of time-varying covariates (such as time, and time by problems with activities of daily living), and underestimate the standard errors of time-invariant covariates (such as age and gender). The standard errors from the random-intercept model are larger than those from logistic regression and GEE models. The choice of models, GEE or random-intercept, depends on the research question and the nature of the covariates. Population-averaged methods are appropriate when between-subjects effects are of interest, and random-effects are useful when subject-specific effects are important.
Successful aging in the Australian longitudinal study of aging: applying the MacArthur model cross-nationally
- Authors:
- ANDREWS Gary, CLARK Michael, LUSZCZ Mary
- Journal article citation:
- Journal of Social Issues, 58(4), Winter 2002, pp.749-765.
- Publisher:
- Wiley
This study used the criteria developed in the MacArthur studies on successful aging to identify subgroups with higher, intermediate, or lower levels of function, and to compare them across a range of other domains. Data were drawn from the Australian Longitudinal Study of Aging (ALSA) in Adelaide, Australia, which is a population-based, bio-psycho-social study of a cohort of 1947 adults aged 70 years or more. Results showed risk and protective effects of successful aging for physical functioning and performance, lifestyle, cognition, affect, and personality. The findings confirm that people age with differing degrees of success and those aging most successfully not only live longer, but also experience a better quality of life.
An exploration of job organisational and environmental factors associated with high and low nursing assistant turnover
- Authors:
- BRANNON Diane, et al
- Journal article citation:
- Gerontologist, 42(2), April 2002, pp.159-168.
- Publisher:
- Oxford University Press
This American article examines factors that distinguish nursing facilities with very high and very low nursing assistant turnover rates from a middle referent group, exploring the possibility that high and low turnover are discrete phenomena with different antecedents. With the exception of registered nurse turnover rate, low turnover and high turnover were not associated with the same factors. Future studies of facility turnover should avoid modeling turnover as a linear function of a single set of predictors in order to provide clearer recommendations for practice.