Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_960C6353CF69
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort.
Journal
BMC health services research
Author(s)
Dupraz J., Henchoz Y., Santos-Eggimann B.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Publication state
Published
Issued date
08/01/2020
Peer-reviewed
Oui
Volume
20
Number
1
Pages
22
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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.
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.
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).
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.
Keywords
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, Male, Switzerland, Determinants, Home care utilization, Longitudinal analysis, Older adults, Trajectories
Pubmed
Web of science
Open Access
Yes
Create date
10/01/2020 11:33
Last modification date
27/04/2020 5:20
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