title: The role of community-based care capacity in shaping risk of long-term care facility placement.
abstract: OBJECTIVE
  Across the developed world, wait lists for facility-based long-term care (LTC) beds continue to grow. Wait lists are primarily driven by the needs of aging populations (demand-side factors). Less attention has been given to system capacity to provide community alternatives to LTC (supply-side factors). We examine the role of both demand- and supply-side factors by comparing the characteristics of individuals who have been assessed and deemed eligible for LTC in urban and rural/underserviced parts of northwestern Ontario, Canada.
  
  
  METHODS
  Home care assessment data were analyzed for all individuals waiting for LTC in northwestern Ontario as of March 2008 (n=858). For the analysis, the sample was separated into urban and rural groups to account for geographical differences in wait list location. Characteristics between these two groups were compared.
  
  
  RESULTS
  Individuals on LTC wait lists in the rural areas were significantly less impaired in activities of daily living and cognition than their counterparts in the urban area. However, in both areas, impairments in lighter-care activities appeared to be a key wait list driver, and few people had an informal caregiver living in the home.
  
  
  CONCLUSIONS
  Our data suggest that LTC wait lists reflect, at least to some extent, insufficient community capacity, not just need for LTC.
authors: Research Scientist, Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Health, Assistant Professor, Institute of Health Policy, Management & Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON.
authors: Kerry
authors: K
authors: Kuluski
authors: A Paul
authors: AP
authors: Williams
authors: Audrey
authors: A
authors: Laporte
authors: Whitney
authors: W
authors: Berta
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012112:Residential Facilities / Q000458:organization & administration / Q000706:statistics & numerical data / Q000600:supply & distribution*; D012189:Retrospective Studies; D012307:Risk Factors; D019035:Rural Health Services; D014850:Waiting Lists
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