Concurrent and Long-Term Predictors of Older Adults’ Use of Community-Based Long-Term Care Services

Bookwala, Jamila; Zdaniuk, Bożena; Burton, Lynda; Lind, Bonnie K.; Jackson, Sharon; Schulz, Richard

doi:10.1177/0898264303260448

Cited by 60 publications

(83 citation statements)

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“…The widely adopted Andersen behavioral model (1995) suggests gender is a predisposing factor that influences health service use. However, empirical studies to date have not found a relationship between gender and overall formal service use (Bookwala et al, 2004;Tennstedt, Crawford, & Delgado, 1998). Thus, if gender differences exist, they may be contingent on the specific type of formal service under examination.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

et al. 2008

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Objective-This study explored how male and female family caregivers of Alzheimer's disease (AD) patients differ in their use of formal services and informal support and how religiousness may affect such differences.Methods-Data were from a sample of 720 family caregivers of AD patients who participated in the Resources for Enhancing Alzheimer's Caregiver Heath (REACH I) study sites in Birmingham, Boston, Memphis, and Philadelphia.Results-Female caregivers were less likely to use in-home services than males (M = 0.83 vs. M = 1.06, p < .01) but reported more use of transportation services (21.6% vs. 12.7%, p < .01) and more use of informal support (M = 13.9 vs. M = 10.7, p < .01). Mediation tests suggested that three measures of religiousness helped explain the relationship between gender and use of formal services and informal support.Discussion-These findings highlight the necessity to assess AD caregivers' religiousness to better understand their circumstances. Keywordsgender; Alzheimer's caregiving; religiousness; service use Women have had a long history as the primary caregivers in American society. With medical advances and increased longevity, this has increasingly included care of older adults. These same factors have also resulted in an increase in the number of males providing care to adults, most often spouses. Males, however, have not had the same tradition of and experiences with caregiving that females have had and thus might approach the task somewhat differently (Calasanti & Bowen, 2006).A substantial proportion of current female AD caregivers was born in the first third of the 20th century and formed many of their views on caregiving during the 1930s and 1940s. Caregiving, both of children and adults, during this time was largely a family/friend matter. Day care was Please address correspondence to Fei Sun, Social Work Department, Arizona State University, #3251, 4701 W. Thunderbird Road, Glendale, AZ, 85306-4908; sun011@bama.ua.edu. NIH Public AccessAuthor Manuscript J Aging Health. Author manuscript; available in PMC 2010 February 10. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript not readily available, elder care programs were nonexistent, and the proportion of married women who worked outside the home was low (Velkoff & Lawson, 1998). Consequently, care systems were largely informal.Beyond the family, the primary institution that provided support and help to individuals was the church. Mothers, perhaps because they had primary responsibility for the socialization of their children, were more heavily involved with the church and thus could, at least on occasion, find support and assistance from the church community (Levitt, 1995). Males from this same era had primary responsibility for providing financially for the family and had less involvement in direct care of children or, in those cases where it occurred, adult care. They also generally had less involvement with the church, at least as a system of social support (Francis, 1997).The biographical context ...

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

et al. 2008

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“…We assessed the impact of predisposing, enabling factors as well as need (Andersen, 1995;Andersen & Newman, 2005;Bass & Noelker, 1987;Bookwala et al, 2004;Geerlings et al, 2005;Geerts & Van der Boch, 2012;Suanet et al, 2012;Hlebec, 2012;Hlebec, 2014) on preferences for care arrangements, focusing on community and organisational enabling factors. To evaluate care arrangements, empirical distributions of care arrangements across all 22 tasks were computed and coded into eight empirically possible care arrangements (Jacobs et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…We also evaluated care arrangements across separate task areas (AADL, IADL and PADL). Care arrangements were defined as follows (Table 1 Like other studies, we constructed the independent variables in the model (Andersen, 1995;Andersen & Newman, 2005;Bass & Noelker, 1987;Bookwala et al 2004;Geerlings et al, 2005;Geerts & Van der Boch, 2012;Suanet et al, 2012;Hlebec, 2012;Hlebec, 2014). We included the following predisposing factors: age, gender, and level of education.…”

Section: Methodsmentioning

confidence: 99%

“…As the third and most important component, need refers to subjective evaluations (perceptions of health, reports of difficulties in managing everyday tasks) and diagnosis (adapted from Hlebec, 2014). Among the enabling factors for care arrangements or social home care usage shown in a number of studies are the availability of an informal carer (child or partner), the degree of urbanisation, income, and caregiver need (Bass & Noelker, 1987;Bookwala, Zdaniuk, Burton, Lind, Jackson & Schulz, 2004;Geerlings, Pot, Twisk & Deeg, 2005;Geerts & Van der Boch, 2012;Suanet, Broese van Groenou & Van Tilburg, 2012). The enabling factors for the scope of social home care in assessing the community and society level include the price of the service, the temporal availability of formal services (Hlebec, 2012;Hlebec, 2014), geographical accessibility of formal services and the relative number of formal carers per users in the community (Hlebec, 2012).…”

Section: Rasp -Research Onmentioning

confidence: 99%

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Influence of Contextual and Organisational Factors on Combining Informal and Formal Care for Older People. Slovenian Case

Hlebec

Hrast

2016

RASP

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The need and availability of informal carers are the most important determinants of care arrangements for older people requiring care. In the present study, we focus on the role of predisposing, enabling factors as well as need in predicting the distribution of care arrangements of social home care users in Slovenia. We not only included individual factors but also community factors and, even more importantly, we addressed the organisational factors which have an effect on formal care usage. In a case study in Slovenia we showed that, apart from need for and availability of an informal care network, which were the strongest predictors of care arrangements (no care, informal care only, formal care only, mixed care) across the activities of daily living, organisational factors such as the temporal availability of social home care and the number of users were the second most important predictors of care arrangements of social home care users. The implications for the conceptual framework for studying care arrangements within national studies as well as in cross-national studies are discussed.

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“…A taxonomia referida em estudos anteriores para identificação de fatores associados ao consumo de recursos segue a abordagem definida nos trabalhos realizados por Andersen e Newman [23] e Andersen [24], que consideram três componentes principais: fatores predisponentes, condições propícias e fatores associados a necessidades específicas [20,[25][26][27]. Na categoria dos fatores predisponentes estão incluídas as características individuais tal como a etnia, a idade e o estado civil [25].…”

Section: Introductionunclassified

A Influência das Características dos Prestadores e dos Utentes no Consumo de Recursos em Unidades de Cuidados Continuados

Santana

Marques

Lopes

et al. 2017

Port J Public Health

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Palavras ChaveOrganização e gestão dos serviços de saúde · Cuidados continuados · Custos em organizações de saúde Resumen Introdução: O envelhecimento populacional, o aumento da prevalência de doenças crónicas e de multipatologia, são fenómenos que encontraram novas respostas com a criação da Rede Nacional de Cuidados Continuados Integrados (RNCCI) em Portugal, a partir de 2006. É esperado que esta estrutura adicional de oferta de cuidados permita contribuir para a criação de valor aos seus utentes. Objetivo: O presente estudo teve como objetivos estimar o consumo de recursos medido através da duração de internamento em unidades de internamento em cuidados continuados (UICC) em Portugal e analisar a associação com as características dos utentes e dos prestadores de cuidados. Método: Foi realizado um estudo transversal e retrospetivo, que utilizou informação da atividade das unidades da RNCCI entre 2010 e 2012. Recorreu-se a modelos de regressão lineares múlti-plos, utilizando a duração de internamento como variável dependente e, como preditores, variáveis representativas das características individuais dos utentes e dos prestadores. Resultados: Para os 30.090 episódios incluídos, a duração média de internamento foi de 34,2 dias nas unidades de convalescença, 84,1 dias nas unidades de média duração e reabilitação e 106 dias nas unidades de longa duração e manutenção. A dispersão da duração de internamento foi elevada em todas as tipologias e regiões. Isoladamente, as variáveis associadas às características dos utentes apresentaram capacidade preditiva muito reduzida. A inclusão das variáveis associadas à organização da oferta de cuidados aumentou a capacidade do modelo explicar a variabilidade do tempo de internamento dos utentes. Conclusão: Os resultados do modelo de regressão linear múltipla sugerem que são as características associadas à oferta de cuidados que apresentam maior relevância para explicar a variabilidade da duração de internamento em cuidados continuados. Sugere-se que futuros desenvolvimentos incluam melhorias nas práticas de registo e a implementação de um sistema de classificação de utentes específico, internacionalmente validado para a estratificação do risco em cuidados continuados.

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Concurrent and Long-Term Predictors of Older Adults’ Use of Community-Based Long-Term Care Services

Abstract: Caregiver-related need variables play a significant role in defining utilization patterns of community-based long-term care services among older adults.

Cited by 60 publications

References 40 publications

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

The Influences of Gender and Religiousness on Alzheimer Disease Caregivers' Use of Informal Support and Formal Services

Influence of Contextual and Organisational Factors on Combining Informal and Formal Care for Older People. Slovenian Case

A Influência das Características dos Prestadores e dos Utentes no Consumo de Recursos em Unidades de Cuidados Continuados

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