{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:56Z","timestamp":1792787276672,"version":"4.5.0"},"reference-count":45,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Government Medical Research Future Fund","award":["2021-2024 PHRDI000009"],"award-info":[{"award-number":["2021-2024 PHRDI000009"]}],"id":[{"id":"https:\/\/ror.org\/0513v5k17","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Australian Government Medical Research Future Fund","award":["2024-2029 NCRI000109"],"award-info":[{"award-number":["2024-2029 NCRI000109"]}],"id":[{"id":"https:\/\/ror.org\/0513v5k17","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Australian Government Medical Research Future Fund","award":["PHRDI000009"],"award-info":[{"award-number":["PHRDI000009"]}],"id":[{"id":"https:\/\/ror.org\/0513v5k17","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Australian Government, National Health and Medical Research Council","award":["GNT119378"],"award-info":[{"award-number":["GNT119378"]}],"id":[{"id":"https:\/\/ror.org\/011kf5r70","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,17]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Objectives<\/jats:title>\n Long-term care facility (LTCF) ownership and location can influence resident outcomes in multiple ways, with concern that they are associated with quality of care and resident outcomes. The aim of this study was to assess whether LTCF ownership was associated with risks of mortality, emergency department (ED) presentations, unplanned hospitalisations and hospital days during the first 12 months after LTCF entry, and whether these associations varied by geographical region in Australia.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A retrospective propensity score-matched cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Registry of Senior Australians National Historical Cohort (2013\u20132018).<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Non-indigenous LTCF residents aged \u226565 years.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n LTCF ownership type: government, not-for-profit or for-profit. Analyses were stratified by LTCF geographical remoteness: metropolitan, inner regional or outer regional\/remote\/very remote area.<\/jats:p>\n <\/jats:sec>\n \n Primary and secondary outcome measures<\/jats:title>\n Cox proportional hazards, Fine-Gray competing risks and negative binomial models were employed. We report adjusted HRs, sub-distribution HRs (sHR), rate ratios, CIs and cumulative incidence estimates.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 205 079 residents studied, 8961 (4.4%) lived in government-run, 105 144 (51.3%) in not-for-profit and 90 974 (44.4%) in for-profit LTCFs. Compared with residents in not-for-profit LTCFs, mortality risk was higher in for-profit (HR=1.17, 95% CI 1.09 to 1.26) and government facilities (HR=1.20, 95% CI 1.08 to 1.35) located in inner regional areas (24.1% of residents). Residents in government LTCFs had lower ED presentation risk than residents in not-for-profit (sHR=0.68, 95% CI 0.57 to 0.82) and for-profit (sHR=0.61, 95% CI 0.52 to 0.72) LTCFs. Similar observations were made for unplanned hospitalisations and hospital days, and across regions.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Government LTCF residents had fewer hospital-related events, while not-for-profit residents had lower mortality, with differences most evident in inner regional areas. Ongoing monitoring of LTCF ownership trends and their association with resident outcomes is vital for policy development.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117917","type":"journal-article","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T15:30:12Z","timestamp":1789918212000},"page":"e117917","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of long-term care facility ownership and location on residents\u2019 mortality and hospitalisations: A population-based retrospective cohort study in Australia"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0845-5459","authenticated-orcid":false,"given":"Miia","family":"Rahja","sequence":"first","affiliation":[{"name":"College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia"},{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling W","family":"Davies","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert N","family":"Jorissen","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-5135","authenticated-orcid":false,"given":"Maria","family":"Crotty","sequence":"additional","affiliation":[{"name":"Rehabilitation, Aged and Extended Care, Flinders Medical Centre, Bedford Park, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Rehabilitation, Aged and Extended Care, Flinders Medical Centre, Bedford Park, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Evans","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Corlis","sequence":"additional","affiliation":[{"name":"Australian Nursing and Midwifery Education Centre, Ridleyton, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Meyer","sequence":"additional","affiliation":[{"name":"Bolton Clarke, Kelvin Grove, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1192-4121","authenticated-orcid":false,"given":"Gillian E","family":"Caughey","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"},{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8261-2665","authenticated-orcid":false,"given":"Maria C","family":"Inacio","sequence":"additional","affiliation":[{"name":"South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia"},{"name":"College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"2026092008300500000_16.9.e117917.1","unstructured":"Department of Health Australia . 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