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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Autor: Prades-Colomé, Albert
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
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spelling Mortality risk factors in Catalonia's long-term care system: a population-based survival analysisPrades-Colomé, AlbertMortalityLong-term careProportional hazard modelsCataloniaAgeingBackground: 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.This work was supported by the Doctoral Industrial Plan of the Ministry of Research and Universities at Generalitat de Catalunya (Government of Catalonia).Elsevier2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/72162http://dx.doi.org/10.1016/j.healthpol.2025.105482reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésHealth Policy. 2025;163:105482© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/bync/4.0/).http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/721622026-05-29T05:05:01Z
dc.title.none.fl_str_mv Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
title Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
spellingShingle Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
Prades-Colomé, Albert
Mortality
Long-term care
Proportional hazard models
Catalonia
Ageing
title_short Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
title_full Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
title_fullStr Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
title_full_unstemmed Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
title_sort Mortality risk factors in Catalonia's long-term care system: a population-based survival analysis
dc.creator.none.fl_str_mv Prades-Colomé, Albert
author Prades-Colomé, Albert
author_facet Prades-Colomé, Albert
author_role author
dc.subject.none.fl_str_mv Mortality
Long-term care
Proportional hazard models
Catalonia
Ageing
topic Mortality
Long-term care
Proportional hazard models
Catalonia
Ageing
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/72162
http://dx.doi.org/10.1016/j.healthpol.2025.105482
url https://hdl.handle.net/10230/72162
http://dx.doi.org/10.1016/j.healthpol.2025.105482
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Health Policy. 2025;163:105482
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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repository.mail.fl_str_mv
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