Observational studyAge and ageing2025
Comparison of mortality and hospitalisation rates amongst older adults residing in professional foster families versus nursing homes: two parallel observational studies.
Observational study in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Poor adjustment to nursing homes and 1-year mortality: a secondary analysis of the KASEHPAD cohort study.BMJ open · 2025Observational
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is an urgent need to offer alternatives to nursing homes. Amongst them, professional foster families with paramedical supervision have never been studied.
objectivesThis study aimed to compare the 1-year mortality, hospitalisation and emergency department visit rates between older adults in foster families and those in nursing homes.
designTwo parallel cohort studies conducted in foster families (n = 107) and nursing homes (n = 332).
methodsAdults aged ≥60 years were followed for 1 year, with assessments at baseline, 6 and 12 months. Primary outcomes included 12-month mortality, hospitalisations and emergency visits without hospitalisation. Secondary outcomes included cognitive decline [Mini-Mental State Examination (MMSE)], functional dependence [activities of daily living (ADL)], and health-related quality of life (EQ-5D).
resultsBaseline characteristics, including comorbidities and cognitive impairment (MMSE ≤18), were similar across groups. However, full functional dependence (ADL = 0) was more frequent amongst foster family residents (35.4% versus 18.2%; P = .01). After 12 months, mortality was 24.2% in foster families and 21.9% in nursing homes [adjusted odd ratio (OR) = 0.83; 95% CI, 0.42-1.66; P = 0.599]. Hospitalisation occurred in 6.1% versus 8.6% (adjusted OR = 0.74; 95% CI, 0.28-2.00; P = .547), and emergency visits in 9.1% versus 9.3% (adjusted OR = 0.94; 95% CI, 0.37-2.37, P = 0.889). Cognitive decline was similar. Foster family residents showed greater functional decline (β = -0.69; P < .001) but better quality of life maintenance (β = 0.08; P = .004).
conclusionProfessional foster families are a viable alternative to nursing homes, achieving comparable health outcomes at 1 year and at lower cost. Their development should consider cultural, clinical, and socioeconomic contexts.
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