Derivation and validation of an algorithm to predict transitions from community to residential long-term care among persons with dementia—A retrospective cohort study

Abstract

Objectives To develop and validate a model to predict time-to-LTC admissions among individuals with dementia. Design Population-based retrospective cohort study using health administrative data. Setting and participants Community-dwelling older adults (65+) in Ontario living with dementia and assessed with the Resident Assessment Instrument for Home Care (RAI-HC) between April 1, 2010 and March 31, 2017. Methods Individuals in the derivation cohort (n = 95,813; assessed before March 31, 2015) were followed for up to 360 days after the index RAI-HC assessment for admission into LTC. We used a multivariable Fine Gray sub-distribution hazard model to predict the cumulative incidence of LTC entry while accounting for all-cause mortality as a competing risk. The model was validated in 34,038 older adults with dementia with an index RAI-HC assessment