Examining the Substitution Effect of Assisted Living Services in Retirement Homes in Ontario, Canada
| dc.contributor.advisor | Costa, Andrew | |
| dc.contributor.author | Manis, Derek | |
| dc.contributor.department | Health Policy | en_US |
| dc.date.accessioned | 2021-11-16T14:41:51Z | |
| dc.date.available | 2021-11-16T14:41:51Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | Retirement homes provide assisted living services in a residential setting to support independent living. Retirement homes predominately operate on a private, for-profit business model, and these homes are privately financed through out-of-pocket payments by residents and/or their caregivers. This thesis examines whether retirement homes are a substitute congregate care setting to long-term care in Ontario, Canada. The first study created the first population-level cohort of residents of retirement homes with health system administrative data in 2018 and compared the health service rates of residents of retirement homes relative to other older adult populations (i.e., residents of long-term care homes, home care recipients who lived in the community, and community-dwelling older adults). This study found that residents of retirement homes were a unique older adult population with the highest relative rates of hospital-based care. The second study examined the facility-level characteristics of retirement homes that provided a dementia care program in 2018. This study found that these retirement homes offered an array of care services and were fundamentally different from those that did not. The third study investigated whether residents of retirement homes who were newly diagnosed with dementia and resided in a retirement home with a dementia care program had a lower rate of transition to a long-term care home from 2014 to 2019. This study found that residents of retirement homes who had access to a dementia care program in their retirement home had a significantly lower rate of transition to a long-term care home. The findings from these three studies suggest retirement homes may be a substitute congregate care home for a long-term care home in Ontario, Canada. These findings inform health system planning, national dementia care strategies, and policies that address housing, health, and social care needs of older adults. | en_US |
| dc.description.degree | Doctor of Philosophy (PhD) | en_US |
| dc.description.degreetype | Dissertation | en_US |
| dc.description.layabstract | This thesis examined whether retirement homes are a substitute for long-term care in Ontario, Canada. The first study created the first population-level cohort of residents of retirement homes and compared their health service use to other older adult populations. Residents of retirement homes had the highest rates of hospital-based care compared to the other older adult populations. The second study investigated the characteristics of retirement homes that provided a dementia care program. The homes that provided a dementia care program offered an array of care services. The third study investigated whether residents of retirement homes who lived with dementia and resided in a retirement home with a dementia care program transitioned more slowly to a long-term care home. Residents of retirement homes who had access to a dementia care program transitioned much slower to a long-term care home. Retirement homes may be a substitute to long-term care. | en_US |
| dc.identifier.uri | http://hdl.handle.net/11375/27168 | |
| dc.language.iso | en | en_US |
| dc.title | Examining the Substitution Effect of Assisted Living Services in Retirement Homes in Ontario, Canada | en_US |
| dc.type | Thesis | en_US |