Background
Methods
Data & participants
Measurements
Dependent variable
Independent variables
Statistical analysis
Results
Descriptive analysis
Variables | Improve (n = 99) | Equal (n = 112) | Decline (n = 158) | Total (n = 369) |
---|---|---|---|---|
Age (years) [mean,SD]
|
79 (7.5) |
80 (7.3) |
82 (7.8) |
81 (7.7) |
Female [n, (%)]
|
72 (73%)
|
79 (71%)
|
103 (65%)
|
254 (69%)
|
Income level [n, (%)]
| ||||
level 1
|
6 (6%)
|
3 (3%)
|
4 (3%)
|
13 (4%)
|
level 2
|
26 (26%)
|
17 (15%)
|
24 (15%)
|
67 (18%)
|
level 3
|
11 (11%)
|
19 (17%)
|
20 (13%)
|
50 (14%)
|
level 4
|
47 (47%)
|
62 (55%)
|
98 (62%)
|
207 (56%)
|
level 5
|
4 (4%)
|
5 (4%)
|
7 (4%)
|
16 (4%)
|
level 6
|
5 (5%)
|
6 (5%)
|
5 (3%)
|
16 (4%)
|
Type of LTC Services [n, (%)]
| ||||
commuting services
|
42 (43%)
|
57 (51%)
|
81 (51%)
|
180 (49%)
|
in-home services
|
34 (34%)
|
32 (29%)
|
34 (22%)
|
100 (27%)
|
mixed
|
23 (23%)
|
23 (20%)
|
43 (27%)
|
89 (24%)
|
Number of LTC Services (monthly) [n, (%)]
| ||||
1 service
|
67 (68%)
|
78 (70%)
|
88 (56%)
|
233 (63%)
|
2 services
|
24 (24%)
|
27 (24%)
|
55 (35%)
|
106 (29%)
|
3+ services
|
8 (8%)
|
7 (6%)
|
15 (9%)
|
30 (8%)
|
Utilization of LTC Services(days/month) [mean,SD]
| ||||
commuting services
|
6.9 (6.23) |
8.4 (5.26) |
9.3 (4.35) |
8.5 (5.18) |
in-home services
|
18.4 (11.12) |
19.2 (11.86) |
24.2 (18.36) |
20.7 (14.30) |
mixed
|
27.2 (13.23) |
26.6 (11.34) |
25.3 (12.08) |
26.1 (12.09) |
Utilization Rate of Benefits [mean,SD]
|
0.324 (0.188) |
0.361 (0.229) |
0.472 (0.228) |
0.399 (0.228) |
Length-of stay in LTCI system (months)
| ||||
(mean, [SD])
|
40 (17.32) |
29 (16.82) |
38 (17.06) |
36 (17.62) |
(median; [min,max])
|
39 (9–72) |
26 (6–69) |
37 (6–72) |
34 (6–72) |
Length-of stay in Care Level 1 (months)
| ||||
(mean, [SD])
|
17 (13.83) |
21 (12.93) |
14 ( 10.93) |
17 (12.72) |
(median, [ min,max])
|
12 (3–61) |
19 (5–61) |
10 ( 3–48) |
14 (3–61) |
Survival analysis
Cox proportional-hazards models
“Improved” disability transition stratum
Models | 6-months | 12-months | 18-months | 24-months | 36-months | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| |
Age
|
0.99
| 0.94 - 1.04 | 0.653 |
0.98
| 0.94 - 1.03 | 0.400 |
1.00
| 0.97 - 1.04 | 0.902 |
1.01
| 0.97 - 1.04 | 0.758 |
1.01
| 0.98 - 1.05 | 0.495 |
Gender
| |||||||||||||||
Male
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
Female
|
4.51
| 1.51 - 13.50 | 0.007 |
3.32
| 1.47 - 7.50 | 0.004 |
1.74
| 0.95 - 3.17 | 0.072 |
1.68
| 0.94 - 3.01 | 0.082 |
1.84
| 1.06 - 3.21 | 0.031 |
Income level
|
0.95
| 0.68 -1.33 | 0.764 |
0.97
| 0.74 - 1.28 | 0.840 |
0.87
| 0.70 - 1.09 | 0.218 |
0.84
| 0.68 - 1.04 | 0.113 |
0.89
| 0.73 - 1.09 | 0.251 |
Length of stay in LTCI system
|
0.96
| 0.94 - 0.98 | 0.001 |
0.97
| 0.95 - 0.99 | 0.001 |
0.96
| 0.95 - 0.98 | <.0001 |
0.96
| 0.95 - 0.98 | <.0001 |
0.96
| 0.95 - 0.98 | <.0001 |
Utilization Rate of Benefits
|
0.24
| 0.02 - 2.68 | 0.245 |
0.14
| 0.02 - 1.10 | 0.061 |
0.24
| 0.05 - 1.23 | 0.087 |
0.34
| 0.07 - 1.65 | 0.182 |
0.48
| 0.11 - 2.10 | 0.332 |
Number of LTC Services
| |||||||||||||||
1 service
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
2 + services
|
0.41
| 0.08 - 2.04 | 0.274 |
0.28
| 0.07 - 1.08 | 0.066 |
0.37
| 0.12 - 1.12 | 0.079 |
0.35
| 0.12 - 1.08 | 0.067 |
0.40
| 0.14 - 1.12 | 0.081 |
Type of LTC Services
| |||||||||||||||
mixed
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
commuting services
|
0.46
| 0.08 - 2.57 | 0.376 |
0.44
| 0.10 - 1.86 | 0.264 |
0.45
| 0.15 - 1.40 | 0.169 |
0.48
| 0.16 - 1.44 | 0.189 |
0.46
| 0.17 - 1.27 | 0.133 |
in-home services
|
0.28
| 0.06 - 1.42 | 0.124 |
0.35
| 0.09 - 1.43 | 0.145 |
0.39
| 0.13 - 1.20 | 0.100 |
0.38
| 0.13 - 1.17 | 0.093 |
0.41
| 0.15 - 1.14 | 0.087 |
Amount of LTC Services (days/month)
|
1.02
| 0.97 - 1.06 | 0.457 |
1.03
| 1.00 - 1.07 | 0.090 |
1.02
| 0.98 - 1.05 | 0.382 |
1.01
| 0.98 - 1.05 | 0.469 |
1.01
| 0.97 - 1.04 | 0.779 |
n / censored
|
210/173
|
210/160
|
210/139
|
210/135
|
210/123
| ||||||||||
Likelihood ratio test
| 0.002 | 0.002 | 0.0011 | 0.001 | <.0001 |
“Declined” disability transition stratum
Models | 6-months | 12-months | 18-months | 24-months | 36-months | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| Hazard ratio | 95% CI |
p-value
| |
Age
|
1.00
| 0.97 - 1.04 | 0.895 |
1.01
| 0.98 - 1.04 | 0.673 |
1.00
| 0.97 - 1.02 | 0.854 |
1.00
| 0.98 - 1.02 | 0.880 |
1.00
| 0.98 - 1.03 | 0.791 |
Gender
| |||||||||||||||
Male
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
Female
|
0.93
| 0.53 - 1.64 | 0.800 |
0.95
| 0.60 - 1.49 | 0.820 |
1.05
| 0.70 - 1.57 | 0.808 |
1.12
| 0.76 - 1.66 | 0.560 |
1.01
| 0.70 - 1.45 | 0.963 |
Income level
|
0.99
| 0.73 - 1.34 | 0.933 |
0.86
| 0.68 - 1.10 | 0.228 |
0.91
| 0.73 -1.12 | 0.364 |
0.92
| 0.75 - 11.3 | 0.417 |
0.88
| 0.72 - 1.07 | 0.201 |
Length of stay in LTCI system
|
0.95
| 0.93 - 0.97 | <.0001 |
0.97
| 0.95 - 0.98 | <.0001 |
0.96
| 0.95 - 0.98 | <.0001 |
0.96
| 0.95 - 0.98 | <.0001 |
0.96
| 0.95 - 0.97 | <.0001 |
Utilization Rate of Benefits
|
0.91
| 0.20 - 4.08 | 0.898 |
1.04
| 0.35 - 3.10 | 0.946 |
1.04
| 0.40 - 2.73 | 0.930 |
1.24
| 0.49 - 3.10 | 0.650 |
1.30
| 0.54 - 3.14 | 0.562 |
Number of LTC Services
| |||||||||||||||
1 service
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
2 + services
|
1.39
| 0.63 - 3.08 | 0.419 |
1.17
| 0.61 - 2.25 | 0.643 |
1.25
| 0.71 - 2.20 | 0.440 |
1.15
| 0.67 - 2.00 | 0.610 |
1.13
| 0.67 - 1.91 | 0.647 |
Type of LTC Services
| |||||||||||||||
Mixed
|
1.00
|
1.00
|
1.00
|
1.00
|
1.00
| ||||||||||
commuting services
|
1.17
| 0.46 - 2.98 | 0.736 |
1.14
| 0.55 - 2.35 | 0.722 |
1.04
| 0.55 - 1.94 | 0.915 |
0.95
| 0.52 - 1.74 | 0.865 |
0.99
| 0.56 - 1.76 | 0.975 |
in-home services
|
0.71
| 0.27 - 1.92 | 0.505 |
1.00
| 0.48 - 2.08 | 0.994 |
0.98
| 0.51 - 1.89 | 0.957 |
0.91
| 0.48 - 1.70 | 0.761 |
1.00
| 0.55 - 1.83 | 0.993 |
Amount of LTC Services (days/month)
|
0.98
| 0.95 - 1.02 | 0.303 |
0.99
| 0.97 - 1.02 | 0.622 |
0.98
| 0.96 - 1.00 | 0.092 |
0.98
| 0.96 - 1.00 | 0.120 |
0.98
| 0.96 - 1.00 | 0.085 |
n / censored
|
269/214
|
269/180
|
269/150
|
269/140
|
269/123
| ||||||||||
Likelihood ratio test
| <.0001 | 0.007 | <.0001 | <.0001 | <.0001 |