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Mortality and nursing home placement of dementia patients in rural and urban areas: a cohort study from the Swedish Dementia Registry
Author(s) -
Roheger Mandy,
Zupanic Eva,
Kåreholt Ingemar,
Religa Dorota,
Kalbe Elke,
Eriksdotter Maria,
GarciaPtacek Sara
Publication year - 2018
Publication title -
scandinavian journal of caring sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.678
H-Index - 66
eISSN - 1471-6712
pISSN - 0283-9318
DOI - 10.1111/scs.12574
Subject(s) - dementia , medicine , rural area , cohort , hazard ratio , gerontology , odds ratio , cohort study , nursing homes , odds , nursing , confidence interval , disease , logistic regression , pathology
Background Life in rural and urban areas differs in regard to social support and health care. Our aim was to examine the association between nursing home placement and survival of patients with dementia living in urban vs. rural areas. Methods We performed a longitudinal cohort study of patients with dementia at time of diagnosis (n = 58 154) and at first follow‐up (n = 21 522) including patients registered from 2007 through 2014 in the Swedish Dementia Registry (SveDem). Descriptive statistics are shown. Odds ratios with 95% CI are presented for nursing home placement and hazard ratios for survival analysis. Results In age‐ and sex‐adjusted analyses, patients living in urban areas were more likely to be in nursing homes at the time of dementia diagnosis than patients in rural areas (1.49, 95% CI : 1.29–1.73). However, there were no differences in rural vs urban areas in either survival after dementia diagnosis (urban: 0.99, 0.95‐1.04, intermediate: 1.00, 0.96–1.04), or nursing home placement at first follow‐up (urban: 1.00, 0.88–1.13; intermediate: 0.95, 0.85–1.06). Conclusion Persons with dementia living in rural areas are less likely to live in a nursing home than their urban counterparts at the time of dementia diagnosis, but these differences disappear by the time of first follow‐up. Differences in access to nursing homes between urban and rural settings could explain these findings. Results should be considered in the future healthcare decisions to ensure equality of health care across rural and urban areas.