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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.
University Hospital Cologne, Germany.
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.ORCID iD: ingemar.kareholt@ki.se
Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
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2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018.
Keywords [en]
SveDem, dementia, nursing home placement, rural areas, urban areas
National Category
Geriatrics Nursing
Identifiers
URN: urn:nbn:se:hj:diva-39384DOI: 10.1111/scs.12574PubMedID: 29656469Scopus ID: 2-s2.0-85045376870Local ID: HHJARNISOAI: oai:DiVA.org:hj-39384DiVA, id: diva2:1204942
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09

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