Factors Influencing the Transition Intentions of LTCI Home Benefit Recipients to Facilities/Hospitals

The goal of elderly care in our society is Aging in Place (AIP). In line with this, the Long-Term Care Insurance (LTCI) system has strengthened home care services. Despite these efforts, many individuals still transition from home care to facility-based services. This study investigates the factors influencing LTCI home benefit recipients' intentions to transition to facility-based services. It aims to distinguish between transitions from home to nursing facilities and from home to long-term care hospitals to identify factors that promote or hinder AIP and derive practical implications for elder welfare. The research applies the Andersen Health Behavioral Model and the Family Caregiver Model to establish a framework. It examines the effects of predisposing factors (gender, age, living alone status), enabling factors (residential area, type of housing occupancy, elderly-friendly living space, satisfaction with home care services), and need factors (number of chronic diseases, long-term care eligibility level, dementia diagnosis, level of independent mobility) of home benefit recipients. Additionally, it considers predisposing factors (gender, age), enabling factors (household income), and need factors (care burden level) of family caregivers on the intention to transition to facility services. Analysis of data from the 2022 Long-Term Care Survey reveals that recipients who are monthly renters, live in less elderly-friendly environments, or have family caregivers with high care burden and income show higher intentions to transition to a facility. Distinct differences were found between transitions to nursing facilities and long-term care hospitals. No significant factors were found for transitions to long-term care hospitals. However, recipients satisfied with home care and living in elderly-friendly spaces preferred AIP over nursing facilities. Conversely, higher caregiver burden and household income increased intentions to transition to nursing facilities. These findings provide practical implications for enhancing elder welfare and promoting AIP.