Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
Background: As populations age, understanding the health impact of long-term care systems is critical for shaping effective policy. Objective: This study investigates the association between long-term care benefits and mortality risk among older adults in Catalonia, Spain, using comprehensive admini...
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:10230/72162 |
| Acceso en línea: | https://hdl.handle.net/10230/72162 http://dx.doi.org/10.1016/j.healthpol.2025.105482 |
| Access Level: | acceso abierto |
| Palabra clave: | Mortality Long-term care Proportional hazard models Catalonia Ageing |
| Sumario: | Background: As populations age, understanding the health impact of long-term care systems is critical for shaping effective policy. Objective: This study investigates the association between long-term care benefits and mortality risk among older adults in Catalonia, Spain, using comprehensive administrative data from July 2015 to December 2024. Methods: The analysis focuses on applicants of long-term care benefits in Catalonia aged 50+, categorizing them by severity of their needs (Grades I-III) and type of benefit received: home care, residential care, a combination of both or no benefit. It applies survival analysis techniques including Kaplan-Meier estimators and Cox proportional hazards models. Results: Individuals with long-term care needs receiving benefits have significantly lower mortality hazards. Notably, individuals transitioning from home to residential care exhibit the most favourable hazard ratios, suggesting that responsive care pathways are associated with better survival outcomes, potentially due to a most accurate matching of care to needs. Residential care alone is associated to higher mortality risk than home care in the population with the highest grades of long-term care needs. Individuals with recognized long-term care needs who do not receive any benefits face significantly higher risks. Mortality risk also varies by sex, age, and clinical profile, with higher hazards observed among men, older individuals, and those with previous haematological, neoplastic, or respiratory conditions. Conclusion: These findings underscore the association between formal long-term care systems and lower mortality risk and emphasize the importance of timely, adaptive care pathways in mitigating health decline among ageing populations. |
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