The effect of older people's economic resources on care home entry under the United Kingdom's long-term care financing system.
OBJECTIVE
To determine how older people's economic resources affect their likelihood of care home entry in the United Kingdom.


METHODS
In 1988, income, home ownership, and health data were collected for 1,425 people aged 75+. Participants received up to five subsequent health assessments before the study endpoint (1999), in which care home entry was also recorded. Care home entry was identified from death certificates for those who died. Using proportional hazards regression, the effect of home ownership and income on the risk of care home entry was estimated, controlling for predisposing, enabling, and need factors, and health service utilization.


RESULTS
Age, living alone, activities of daily living restriction, cognitive impairment, poor/fair self-perceived health, and contact with services increased the risk of care home entry. Home ownership decreased it. Gender was not a significant predictor of care home entry once other factors were controlled for, and no significant effect was found for income.


CONCLUSIONS
UK public authorities can require older home owners to use the value of their homes to pay for institutional but not community-based care, thus producing a financial incentive to place home owners in institutional settings. However, we find that home ownership reduces the likelihood of care home entry, suggesting that other factors dominate the decision process.
Nuffield Community Care Studies Unit, Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, United Kingdom. rmh52@le.ac.uk
Ruth
R
Hancock
Antony
A
Arthur
Carol
C
Jagger
Ruth
R
Matthews
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006707:Homes for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D010067:Ownership; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D006113:United Kingdom