• Derek R Manis, Jeffrey W Poss, Aaron Jones, Paula A Rochon, Susan E Bronskill, Michael A Campitelli, Richard Perez, Nathan M Stall, Ahmad Rahim, Glenda Babe, Jean-Éric Tarride, Julia Abelson, and Andrew P Costa.
• Centre for Health Economics and Policy Analysis (Manis, Tarride, Abelson, Costa), and Department of Health Research Methods, Evidence, and Impact (Manis, Jones, Tarride, Abelson, Costa), Department of Medicine (Costa), McMaster University; Programs for Assessment of Technology in Health (Tarride), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton; Centre for Integrated Care (Costa), St. Joseph's Health System, Hamilton, Ont.; ICES Central (Manis, Rochon, Bronskill, Campitelli, Perez, Rahim, Babe, Costa), Toronto, Ont.; School of Population and Public Health (Poss), University of Waterloo, Waterloo, Ont.; Women's College Research Institute (Rochon, Bronskill, Stall); Institute for Health Policy, Management & Evaluation (Rochon, Bronskill, Stall), and Division of Geriatric Medicine (Rochon), Faculty of Medicine, University of Toronto; Sunnybrook Research Institute (Bronskill); Division of General Internal Medicine and Geriatrics (Stall), Sinai Health and University Health Network; National Institute on Ageing, Ryerson University (Stall), Toronto, Ont.; Schlegel Research Institute for Aging (Costa), Waterloo, Ont.
• CMAJ. 2022 May 30; 194 (21): E730-E738.

BackgroundBecause there are no standardized reporting systems specific to residents of retirement homes in North America, little is known about the health of this distinct population of older adults. We evaluated rates of health services use by residents of retirement homes relative to those of residents of long-term care homes and other populations of older adults.MethodsWe conducted a retrospective cohort study using population health administrative data from 2018 on adults 65 years or older in Ontario. We matched the postal codes of individuals to those of licensed retirement homes to identify residents of retirement homes. Outcomes included rates of hospital-based care and physician visits.ResultsWe identified 54 733 residents of 757 retirement homes (mean age 86.7 years, 69.0% female) and 2 354 385 residents of other settings. Compared to residents of long-term care homes, residents of retirement homes had significantly higher rates per 1000 person months of emergency department visits (10.62 v. 4.48, adjusted relative rate [RR] 2.61, 95% confidence interval [CI] 2.55 to 2.67), hospital admissions (5.42 v. 2.08, adjusted RR 2.77, 95% CI 2.71 to 2.82), alternate level of care (ALC) days (6.01 v. 2.96, adjusted RR 1.51, 95% CI 1.48 to 1.54), and specialist physician visits (6.27 v. 3.21, adjusted RR 1.64, 95% CI 1.61 to 1.68), but a significantly lower rate of primary care visits (16.71 v. 108.47, adjusted RR 0.13, 95% CI 0.13 to 0.14).InterpretationResidents of retirement homes are a distinct population with higher rates of hospital-based care. Our findings can help to inform policy debates about the need for more coordinated primary and supportive health care in privately operated congregate care homes.© 2022 CMA Impact Inc. or its licensors.

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