Long-term care facility admissions according to type and duration of home- and community-based services among beneficiaries with dementia in Korea.

Background: Dementia significantly increases long-term care (LTC) facility admission. However, the impact of home- and community-based services (HCBS) type and duration on facility admissions remains unclear.

Purpose: We examined LTC facility admissions according to type (home, day, and combined care) and duration (<6 vs. ≥6 months) of HCBS among beneficiaries with dementia.

Methods: This retrospective cohort study used the National Health Insurance and LTC Insurance datasets (2017-2019), including 14,011 beneficiaries with dementia. Multiple logistic regression and Cox proportional hazards regression analyses were performed.

Discussion: Day care or combined care users were more likely to be admitted than home care users. Conversely, sustained HCBS utilization (≥6 months) reduced admission risk compared with shorter utilization (<6 months).

Conclusion: Promoting individualized home care services and encouraging sustained HCBS utilization may delay institutionalization, enhance outcomes, support nurse-led strategies in designing and implementing individualized home care, and contribute to healthcare system sustainability.