Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort
| العنوان: | Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort |
|---|---|
| المؤلفون: | Brigitte Santos-Eggimann, Yves Henchoz, Julien Dupraz |
| المصدر: | BMC health services research, vol. 20, no. 1, pp. 22 BMC Health Services Research BMC Health Services Research, Vol 20, Iss 1, Pp 1-12 (2020) |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Gerontology, Male, medicine.medical_specialty, Home care utilization, Aged, Chronic Disease, Cohort Studies, Facilities and Services Utilization/statistics & numerical data, Female, Health Care Surveys, Home Care Services/statistics & numerical data, Humans, Independent Living, Logistic Models, Switzerland, Determinants, Longitudinal analysis, Older adults, Trajectories, Population, Context (language use), Health administration, 03 medical and health sciences, 0302 clinical medicine, medicine, 030212 general & internal medicine, education, education.field_of_study, business.industry, lcsh:Public aspects of medicine, 030503 health policy & services, Health Policy, Public health, Nursing research, lcsh:RA1-1270, Home Care Services, Cohort, 0305 other medical science, business, Independent living, Facilities and Services Utilization, Cohort study, Research Article |
| الوصف: | Background Given the increasing importance of formal home care services in policies dedicated to elder care, there is major interest in studying individuals’ characteristics determining their utilization. The main objective of this research was to quantify, during a 6-year timeframe, home care use trajectories followed by community-dwelling participants in a cohort study of older adults. The secondary objective was to identify factors associated with home care utilization using Andersen’s Behavioural Model of Health Services Use. Methods We proceeded to an analysis of data prospectively collected in the setting of the Lc65+ population-based study conducted in Lausanne (Switzerland). Self-reported utilization of professional home care in 2012 and 2018 was used to define trajectories during this timeframe (i.e. non-users, new users, former users and continuing users). Bivariable analyses were performed to compare new users to non-users regarding the three dimensions of Andersen’s model (predisposing, enabling and need factors) measured at baseline. Then, binomial logistic regression was used in a series of two hierarchical models to adjust for need factors first, before adding predisposing and enabling factors in a second model. Results Of 2155 participants aged between 69 and 78 in 2012, 82.8% remained non-users in 2018, whereas 11.2% started to use professional home care. There were 3.3% of continuing users and 2.7% of former users. New users exhibited a higher burden of physical and psychological complaints, chronic health conditions and functional limitations at baseline. After adjusting for these need factors, odds of home care utilization were higher only in participants reporting a difficult financial situation (OR 1.65, 95% CI 1.12–2.45). Conclusions In the setting of a Swiss city, incident utilization of formal home care by older adults appeared to be largely determined by need factors. Modifiable factors like personal beliefs and knowledge about home care services did not play a role. After adjusting for need, odds of becoming home care user remained higher in participants reporting a difficult financial situation, suggesting such vulnerability does not hamper access to professional home care in this specific context. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e605de4cccf0189fc6b69c97ab41c394 https://serval.unil.ch/notice/serval:BIB_960C6353CF69 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e605de4cccf0189fc6b69c97ab41c394 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |