Titre
Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Dupraz, J.
Auteure/Auteur
Henchoz, Y.
Auteure/Auteur
Santos-Eggimann, B.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1472-6963
Statut éditorial
Publié
Date de publication
2020-01-08
Volume
20
Numéro
1
Première page
22
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
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.
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.
PID Serval
serval:BIB_960C6353CF69
PMID
Open Access
Oui
Date de création
2020-01-10T10:33:14.365Z
Date de création dans IRIS
2025-05-21T04:56:02Z
Fichier(s)![Vignette d'image]()
En cours de chargement...
Nom
Dupraz_BMCHealthServRes_2020.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
553.56 KB
Format
Adobe PDF
PID Serval
serval:BIB_960C6353CF69.P001
URN
urn:nbn:ch:serval-BIB_960C6353CF692
Somme de contrôle
(MD5):f3124fd271f5a1232a98eb28488748c4