Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Li, Fen; Fang, Xinye; Gao, Xin; Ding, Haiyang; Wang, Changying; Xie, Chunyan; Yu, Yan; Jin, Chunlin

doi:10.1371/journal.pone.0176548

Cited by 22 publications

(25 citation statements)

References 34 publications

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“…Consistent with the prediction of Anderson's behavioural model and evidence from the US and European countries, this study shows that both self‐reported needs and functional limitations are important predictors of care receipt in China. This also concurs with the evidence reported in a previous study conducted in the Jing'an District of Shanghai, China (Li et al, ). Perceived proximity of care is found to be the most important predictor of care use, with its effect size being much higher than that of other predictors.…”

Section: Discussionsupporting

confidence: 93%

“…Older people in the higher age bands and reporting IADL or ADL disabilities are more likely to receive financial support from the government rather than paying for services themselves. of Shanghai, China (Li et al, 2017). Perceived proximity of care is found to be the most important predictor of care use, with its effect size being much higher than that of other predictors.…”

Section: Independent Variablesmentioning

confidence: 86%

“…Due to its short history in the Chinese welfare system, the empirical evidence regarding the determinants of care receipt in this country is limited. The exception is Li et al (2017) work, which investigated this issue in Shanghai, a city that has spearheaded the development of social care services since the early 2000s (Wu, Carter, Goins, & Cheng, 2005).…”

Section: De Terminants Of C Are Receip T: a Liter Ature Re Vie Wmentioning

confidence: 99%

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Home and community care for older people in urban China: Receipt of services and sources of payment

Wang

et al. 2019

Health Soc Care Community

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This study investigates the characteristics of Chinese older people receiving home and community care and the factors associated with the sources of payment for care services. The data come from the Social Survey of Older People in Urban China, which collected information from a random sample of 3,247 older people aged 60 and over in 10 large cities in different regions of China in 2017. Anderson's behavioural model of care utilisation is used to guide the analyses. The study identifies four striking features of the Chinese social care system. First, although disabilities are a significant predictor of receiving home and community care, a large proportion of care recipients do not have disabilities. Second, perceived proximity of care is the most important predictor, which implies high elasticity of demand for care services with regard to perceived distance and the great geographical inequality of care resources in the cities. Third, the government policies support the use of the internet to facilitate care access, but the enabling effect of the internet among older people is limited. Finally, sources of payment for care differ significantly according to people's age, living arrangements, disability and level of education. We argue that the government should consider shifting the focus of financial support from service providers to care recipients in the future.

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Section: Discussionsupporting

confidence: 93%

Section: Independent Variablesmentioning

confidence: 86%

Section: De Terminants Of C Are Receip T: a Liter Ature Re Vie Wmentioning

confidence: 99%

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Home and community care for older people in urban China: Receipt of services and sources of payment

Wang

et al. 2019

Health Soc Care Community

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“…When applying Andersen's model to home care use, the preeminence of need factors was obvious. The association with limitations in ADL/IADL has already been extensively established and, in our case, was further strengthened by taking into account their evolution over the study period [7,8,[17][18][19][20][21][22][23]. In a logistic regression model including this variable, the number of other need factors remaining significantly associated with home care utilization was actually limited.…”

Section: Discussionmentioning

confidence: 70%

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

Dupraz

Henchoz

Santos-Eggimann

2020

BMC Health Serv Res

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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+ populationbased 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.

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“…It would appear that only one study (Simon, Kumar, & Kendrick, 2008) The predictors of stroke survivors' formal and informal caregiving needs are still unknown. Studies on other patient populations, such as patients with dementia and those of advanced age, have indicated that higher numbers of hours of formal and informal care are associated with greater disease severity, increases in behavioural problems, increased difficulties in performing the ADL (Bakker et al, 2013), older age, female gender, not having a spouse, higher income, and presence of stroke or dementia (Li et al, 2017;Rogero-Garcia, 2009). To date, the formal and informal care received by stroke survivors during the first year of home discharge has not been precisely quantified.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Formal and informal care after stroke: A longitudinal analysis of survivors’ post rehabilitation hospital discharge

Pucciarelli

Ausili

Rebora

et al. 2019

Journal of Advanced Nursing

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Aims To describe the type and the amount of formal and informal care received during the first year after home discharge and to identify the baseline predictors of the formal and informal care needs of stroke survivors. Design Longitudinal study. Data were collected between June 2013–May 2016. Methods Survivors (N = 415) were enrolled during discharge from rehabilitation hospitals and interviewed at 3 (T1), 6 (T2), 9 (T3), and 12 (T4) months. The linear mixed effects model with random intercept and random slopes was used to trend for the amount of formal and informal care received by survivors during the four observation times. Results Regarding formal care, only physiotherapy and speech therapy decreased significantly over time. Stroke survivors received a mean of 17 hr of paid informal care per week at T1 and these hours did not significantly decrease after one year from discharge, while unpaid informal care decreased significantly over time. Higher numbers of paid informal caregiving were predicted by older age, higher education levels, lower physical functioning, and living without unpaid informal caregivers while higher numbers of unpaid informal care were predicted by lower physical functioning and living with unpaid informal caregivers. Conclusions Stroke has a great effect on survivors’ lives. During the first few months after rehabilitation hospital discharge, survivors need further care because they are often discharged before achieving independent functioning. Impact The results of this study could be important to guide future interventions aimed at imporving stroke survivors' conditions after post rehabilitation hospital discharge.

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Determinants of formal care use and expenses among in-home elderly in Jing’an district, Shanghai, China

Cited by 22 publications

References 34 publications

Home and community care for older people in urban China: Receipt of services and sources of payment

Home and community care for older people in urban China: Receipt of services and sources of payment

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

Formal and informal care after stroke: A longitudinal analysis of survivors’ post rehabilitation hospital discharge

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