Long-term care facility admissions according to type and duration of home- and community-based services among beneficiaries with dementia in Korea

Abstract

Background: Dementia significantly increases long-term care (LTC) facility admission. However, the impact of home-and community-based services (HCBS) type and duration on facility admissions remains unclear. Purpose: We examined LTC facility admissions according to type (home, day, and combined care) and duration (< 6 vs. >= 6 months) of HCBS among beneficiaries with dementia. Methods: This retrospective cohort study used the National Health Insurance and LTC Insurance datasets (2017-2019), including 14,011 beneficiaries with dementia. Multiple logistic regression and Cox proportional hazards regression analyses were performed. Discussion: Day care or combined care users were more likely to be admitted than home care users. Conversely, sustained HCBS utilization (>= 6 months) reduced admission risk compared with shorter utilization (< 6 months). Conclusion: Promoting individualized home care services and encouraging sustained HCBS utilization may delay institutionalization, enhance outcomes, support nurse-led strategies in designing and implementing individualized home care, and contribute to healthcare system sustainability. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.