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BMC Public Health
Published in: BMC Public Health 1/2021

01-12-2021 | Care | Research article

Predictive factors for entry to long-term residential care in octogenarian Māori and non-Māori in New Zealand, LiLACS NZ cohort

Authors: Marycarol Holdaway, Janine Wiles, Ngaire Kerse, Zhenqiang Wu, Simon Moyes, Martin J. Connolly, Oliver Menzies, Ruth Teh, Marama Muru-Lanning, Merryn Gott, Joanna B. Broad

Published in: BMC Public Health | Issue 1/2021

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Abstract

Background

Long-term residential care (LTC) supports the most vulnerable and is increasingly relevant with demographic ageing. This study aims to describe entry to LTC and identify predictive factors for older Māori (indigenous people of New Zealand) and non-Māori.

Methods

LiLACS-NZ cohort project recruited Māori and non-Māori octogenarians resident in a defined geographical area in 2010. This study used multivariable log-binomial regressions to assess factors associated with subsequent entry to LTC including: self-identified ethnicity, demographic characteristics, self-rated health, depressive symptoms and activities of daily living [ADL] as recorded at baseline. LTC entry was identified from: place of residence at LiLACS-NZ interviews, LTC subsidy, needs assessment conducted in LTC, hospital discharge to LTC, and place of death.

Results

Of 937 surveyed at baseline (421 Māori, 516 non-Māori), 77 already in LTC were excluded, leaving 860 participants (mean age 82.6 +/− 2.71 years Māori, 84.6 +/− 0.52 years non-Māori). Over a mean follow-up of 4.9 years, 278 (41% of non-Māori, 22% of Māori) entered LTC; of the 582 who did not, 323 (55%) were still living and may yet enter LTC. In a model including both Māori and non-Māori, independent risks factors for LTC entry were: living alone (RR = 1.52, 95%CI:1.15–2.02), self-rated health poor/fair compared to very good/excellent (RR = 1.40, 95%CI:1.12–1.77), depressive symptoms (RR = 1.28, 95%CI:1.05–1.56) and more dependent ADLs (RR = 1.09, 95%CI:1.05–1.13). For non-Māori compared to Māori the RR was 1.77 (95%CI:1.39–2.23). In a Māori-only model, predictive factors were older age and living alone. For non-Māori, factors were dependence in more ADLs and poor/fair self-rated health.

Conclusions

Non-Māori participants (predominantly European) entered LTC at almost twice the rate of Māori. Factors differed between Māori and non-Māori. Potentially, the needs, preferences, expectations and/or values may differ correspondingly. Research with different cultural/ethnic groups is required to determine how these differences should inform service development.
Appendix
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Metadata
Title
Predictive factors for entry to long-term residential care in octogenarian Māori and non-Māori in New Zealand, LiLACS NZ cohort
Authors
Marycarol Holdaway
Janine Wiles
Ngaire Kerse
Zhenqiang Wu
Simon Moyes
Martin J. Connolly
Oliver Menzies
Ruth Teh
Marama Muru-Lanning
Merryn Gott
Joanna B. Broad
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Care
Published in
BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09786-z

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