Do home modifications reduce care home admissions for older people? A matched control evaluation of the Care & Repair Cymru service in Wales

Hollinghurst, Joe, Fry, Richard, Akbari, Ashley, Watkins, Alan, Williams, Neil, Hillcoat-Nalletamby, Sarah, Lyons, Ronan A, Clegg, Andrew and Rodgers, Sarah E ORCID: 0000-0002-4483-0845 (2020) Do home modifications reduce care home admissions for older people? A matched control evaluation of the Care & Repair Cymru service in Wales. AGE AND AGEING, 49 (6). pp. 1056-1061.

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Abstract

<h4>Background</h4>home advice and modification interventions aim to promote independent living for those living in the community, but quantitative evidence of their effectiveness is limited.<h4>Aim</h4>assess the risk of care home admissions for people with different frailty levels receiving home advice and modification interventions against a control group who do not.<h4>Study design and setting</h4>matched control evaluation using linked longitudinal data from the Secure Anonymised Information Linkage (SAIL) Databank, comprising people aged 60-95, registered with a SAIL contributing general practice. The intervention group received the Care & Repair Cymru (C & RC) service, a home advice and modification service available to residents in Wales.<h4>Methods</h4>frailty, age and gender were used in propensity score matching to assess the Hazard Ratio (HR) of care home admissions within a 1-, 3- and 5-year period for the intervention group (N = 93,863) compared to a matched control group (N = 93,863). Kaplan-Meier curves were used to investigate time to a care home admission.<h4>Results</h4>the intervention group had an increased risk of a care home admission at 1-, 3- and 5-years [HR (95%CI)] for those classified as fit [1-year: 2.02 (1.73, 2.36), 3-years: 1.87 (1.72, 2.04), 5-years: 1.99 (1.86, 2.13)] and mildly frail [1-year: 1.25 (1.09, 1.42), 3-years: 1.25 (1.17, 1.34), 5-years: 1.30 (1.23, 1.38)], but a reduced risk of care home admission for moderately [1-year: 0.66 (0.58, 0.75), 3-years: 0.75 (0.70, 0.80), 5-years: 0.83 (0.78, 0.88)] and severely frail individuals [1-year: 0.44 (0.37, 0.54), 3-years: 0.54 (0.49, 0.60), 5-years: 0.60(0.55, 0.66)].<h4>Conclusions</h4>HRs indicated that the C & RC service helped to prevent care home admissions for moderately and severely frail individuals. The HRs generally increased with follow-up duration.

Item Type:	Article
Uncontrolled Keywords:	frailty, older people, care homes, interventions, administrative data
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	21 Jul 2021 09:11
Last Modified:	04 Oct 2023 06:51
DOI:	10.1093/ageing/afaa158
Open Access URL:	http://doi.org/10.1093/ageing/afaa158
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3130812