WITHDRAWN: Institutional versus at-home long term care for functionally dependent older people

Area of Science:

• Gerontology
• Health Services Research
• Public Health Policy

Background:

• Growing population of functionally dependent older adults requires comprehensive care.
• Governments are prioritizing community care to reduce costs and improve quality.
• Evidence on the cost-effectiveness of institutional versus at-home care is limited.

Purpose of the Study:

• To evaluate the impact of institutional care compared to at-home care for functionally dependent older individuals.
• To assess effects on health outcomes, satisfaction, quality of care, and costs.

Main Methods:

• Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to 1999.
• Included randomized trials, controlled clinical trials, controlled before and after studies, and interrupted time series.
• Data extracted and quality assessed by three independent reviewers; no meta-analysis due to limited studies.

Main Results:

• Only one small, low-quality study involving 112 participants was identified, comparing community care programs (foster care) with nursing home care.
• No significant differences were observed in functioning (Activities of Daily Living, Instrumental Activities of Daily Living), mental status, perceived health, life satisfaction, or mortality.
• No studies were found on older adults returning to their own homes from institutional care.

Conclusions:

• Insufficient evidence exists to determine the benefits, harms, or costs of institutional versus at-home care for functionally dependent older people.
• Further rigorous research is essential to inform policy and practice in elder care.