Declining demands or constraining supply? Explaining the trend of care home entry in England 2001–2021.
Objectives Despite population aging, care home residency in England has declined over time. However, little is known about the drivers of this decline, particularly the role of supply-side factors. Guided by the Andersen Behavioral Model, this study examines how predisposing, enabling, need, and sup...
| Publicado en: | Journals of Gerontology Series B: Psychological Sciences & Social Sciences Vol. 81; no. 8; pp. 1 - 13 |
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| Autores principales: | , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Aug2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195931923&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195931923 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10795014 JGB jtl: Journals of Gerontology Series B: Psychological Sciences & Social Sciences issn: 10795014 maglogo: N pubinfo: dt: Aug2026 vid: 81 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195931923 10.1093/geronb/gbag104 ppf: 1 ppct: 12 formats: tig: atl: Declining demands or constraining supply? Explaining the trend of care home entry in England 2001–2021. aug: au: Zhang, Jingwen Petrillo, Maria Bennett, Matthew R Pryce, Gwilym affil: Department of Sociology, School of Social Sciences, The University of Manchester, Manchester, United KingdomESRC Centre for Care, United Kingdom ESRC Centre for Care, United KingdomSchool of Sociological Studies, Politics and International Relations, Centre for International Research on Care, Labour and Inequalities (CIRCLE), University of Sheffield, Sheffield, United Kingdom ESRC Centre for Care, United KingdomSchool of Social Policy and Society, University of Birmingham, Birmingham, United Kingdom ESRC Centre for Care, United KingdomSchool of Economics, University of Sheffield, Sheffield, United Kingdom su: England Health services accessibility Institutional care Health status indicators Home ownership Population health Nursing care facilities Marital status Senior housing Active aging Health care rationing Psychosocial factors Hospital utilization Nursing home residents Research funding Long-term health care Logistic regression analysis Descriptive statistics Longitudinal method Mathematical models Medical needs assessment Theory Residential care sug: subj: Health services accessibility Institutional care Health status indicators Home ownership Population health Nursing care facilities Marital status Senior housing Active aging Health care rationing Psychosocial factors England Residential Mental Health and Substance Abuse Facilities Other Residential Care Facilities Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Assisted Living Facilities for the Elderly Hospital utilization Nursing home residents Research funding Long-term health care Logistic regression analysis Descriptive statistics Longitudinal method Mathematical models Medical needs assessment Theory Residential care keyword: aged aging beds contextual factors copyrightHolder:The Gerontological Society of America copyrightYear:2026 directories equity glycogen storage disease type iv healthy aging https://dx.doi.org/10.1093/geronb/gbag104 inLanguage:en institutionalization internship and residency life event long-term care marriage Nonlinear decomposition Nursing home nursing homes occipital nerve stimulation population health publisher:Oxford University Press quality of care resource allocation sameAs:https://pubmed.ncbi.nlm.nih.gov/42262231/ semantic web aged aging beds contextual factors copyrightHolder:The Gerontological Society of America copyrightYear:2026 directories equity glycogen storage disease type iv healthy aging https://dx.doi.org/10.1093/geronb/gbag104 inLanguage:en institutionalization internship and residency life event long-term care marriage Nonlinear decomposition Nursing home nursing homes occipital nerve stimulation population health publisher:Oxford University Press quality of care resource allocation sameAs:https://pubmed.ncbi.nlm.nih.gov/42262231/ semantic web ab: Objectives Despite population aging, care home residency in England has declined over time. However, little is known about the drivers of this decline, particularly the role of supply-side factors. Guided by the Andersen Behavioral Model, this study examines how predisposing, enabling, need, and supply-side contextual factors are associated with care home entry and identifies the mechanisms underlying the decline in institutional care use over time. Methods Using newly linked data from the ONS Longitudinal Study 2001–2021 and the Care Quality Commission care directory (n = 89,122), we estimated logistic regression models to identify key predictors of care home entry. We then applied a nonlinear decomposition to quantify the contributions of compositional changes and changing associations to the declining trends over time. Results The rates of people aged 65 years and older moving from private households to care homes declined from 5.5% in 2001–2011 to 4.0% in 2011–2021. Poor health remained the strongest predictor of care home entry in both periods, while homeownership, being married, and lower local care home bed supply were associated with reduced likelihood of admission. Decomposition results showed that 85.3% of the decline was explained by compositional changes, primarily improvements in population health, alongside reduced supply of care home beds and shifting ethnic composition. Discussion The findings indicate that promoting healthy aging remains central to delaying institutionalization, while declining institutional capacity raises concerns about future access and equity in long-term care provision. This study also offers insights for care home projections and effective resource allocation. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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