TY - JOUR
T1 - Factors Associated with Transition from Community to Permanent Residential Aged Care Following Stroke
T2 - A Linked Registry Data Study
AU - Westworth, Sarah E.
AU - Ung, David
AU - Dalli, Lachlan L.
AU - Barnden, Rebecca
AU - Kilkenny, Monique F.
AU - Srikanth, Velandai
AU - Lannin, Natasha A.
AU - Lodge, Margot E.
AU - Cadilhac, Dominique A.
AU - Olaiya, Muideen T.
AU - Andrew, Nadine E.
AU - on behalf of the PRECISE investigators
N1 - Funding Information:
This article was supported by the Howard Hughes Medical Institute. This work was funded by the National Health and Medical Research Council Australia Project Grant Scheme (1141848). The following authors received research fellowship support from the National Health and Medical Research Council of Australia during this research: Dr Kilkenny (1109426), Dr Cadilhac (1154273), and Dr Andrew (1072053). Dr Kilkenny (105737) and Dr Lannin (102055) are supported by the Future Leader Fellowships from the National Heart Foundation of Australia. The study funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: Understanding factors that influence the transition to permanent residential aged care following a stroke or transient ischemic attack may inform strategies to support people to live at home longer. We aimed to identify the demographic, clinical, and system factors that may influence the transition from living in the community to permanent residential care in the 6 to 18 months following stroke/transient ischemic attack. METHODS: Linked data cohort analysis of adults from Queensland and Victoria aged ≥65 years and registered in the Australian Stroke Clinical Registry (2012-2016) with a clinical diagnosis of stroke/transient ischemic attack and living in the community in the first 6 months post-hospital discharge. Participant data were linked with primary care, pharmaceutical, aged care, death, and hospital data. Multivariable survival analysis was performed to determine demographic, clinical, and system factors associated with the transition to permanent residential care in the 6 to 18 months following stroke, with death modeled as a competing risk. RESULTS: Of 11 176 included registrants (median age, 77.2 years; 44% female), 520 (5%) transitioned to permanent residential care between 6 and 18 months. Factors most associated with transition included the history of urinary tract infections (subhazard ratio [SHR], 1.41 [95% CI, 1.16-1.71]), dementia (SHR, 1.66 [95% CI, 1.14-2.42]), increasing age (65-74 versus 85+ years; SHR, 1.75 [95% CI, 1.31-2.34]), living in regional Australia (SHR, 31 [95% CI, 1.08-1.60]), and aged care service approvals: respite (SHR, 4.54 [95% CI, 3.51-5.85]) and high-level home support (SHR, 1.80 [95% CI, 1.30-2.48]). Protective factors included being dispensed antihypertensive medications (SHR, 0.68 [95% CI, 0.53-0.87]), seeing a cardiologist (SHR, 0.72 [95% CI, 0.57-0.91]) following stroke, and less severe stroke (SHR, 0.71 [95% CI, 0.58-0.88]). CONCLUSIONS: Our findings provide an improved understanding of factors that influence the transition from community to permanent residential care following stroke and can inform future strategies designed to delay this transition.
AB - BACKGROUND: Understanding factors that influence the transition to permanent residential aged care following a stroke or transient ischemic attack may inform strategies to support people to live at home longer. We aimed to identify the demographic, clinical, and system factors that may influence the transition from living in the community to permanent residential care in the 6 to 18 months following stroke/transient ischemic attack. METHODS: Linked data cohort analysis of adults from Queensland and Victoria aged ≥65 years and registered in the Australian Stroke Clinical Registry (2012-2016) with a clinical diagnosis of stroke/transient ischemic attack and living in the community in the first 6 months post-hospital discharge. Participant data were linked with primary care, pharmaceutical, aged care, death, and hospital data. Multivariable survival analysis was performed to determine demographic, clinical, and system factors associated with the transition to permanent residential care in the 6 to 18 months following stroke, with death modeled as a competing risk. RESULTS: Of 11 176 included registrants (median age, 77.2 years; 44% female), 520 (5%) transitioned to permanent residential care between 6 and 18 months. Factors most associated with transition included the history of urinary tract infections (subhazard ratio [SHR], 1.41 [95% CI, 1.16-1.71]), dementia (SHR, 1.66 [95% CI, 1.14-2.42]), increasing age (65-74 versus 85+ years; SHR, 1.75 [95% CI, 1.31-2.34]), living in regional Australia (SHR, 31 [95% CI, 1.08-1.60]), and aged care service approvals: respite (SHR, 4.54 [95% CI, 3.51-5.85]) and high-level home support (SHR, 1.80 [95% CI, 1.30-2.48]). Protective factors included being dispensed antihypertensive medications (SHR, 0.68 [95% CI, 0.53-0.87]), seeing a cardiologist (SHR, 0.72 [95% CI, 0.57-0.91]) following stroke, and less severe stroke (SHR, 0.71 [95% CI, 0.58-0.88]). CONCLUSIONS: Our findings provide an improved understanding of factors that influence the transition from community to permanent residential care following stroke and can inform future strategies designed to delay this transition.
KW - home care services
KW - humans
KW - information storage and retrieval
KW - inpatients
KW - stroke
UR - http://www.scopus.com/inward/record.url?scp=85178500413&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.123.043972
DO - 10.1161/STROKEAHA.123.043972
M3 - Article
C2 - 37955141
AN - SCOPUS:85178500413
SN - 0039-2499
VL - 54
SP - 3117
EP - 3127
JO - Stroke
JF - Stroke
IS - 12
ER -