Determinants of Unmet Needs Among Slovenian Old Population

Hlebec, Valentina; Srakar, Andrej; Majcen, Boris

doi:10.1515/sjph-2016-0011

Cited by 18 publications

(24 citation statements)

References 22 publications

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“…Disparities which were observed between rural and urban settlements are not surprising, as they are observed in other countries as well ( 15 , 26 , 29 , 31 , 32 , 33 , 35 ). Financial constraints most likely enhance lower availability of services in rural areas and higher probability of having unmet needs ( 35 ). Informal care is related to the lack of financial resources, while the usage of formal services is often related to the financial status of care recipients and their families ( 34 ).…”

Section: Discussionsupporting

confidence: 60%

Evaluation of access to long-term care services for old people ageing in place in Slovenia

Hlebec

2018

Slovenian Journal of Public Health

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TheoryThe quality of long-term care services has an important effect on the quality of life of their users and their informal carers. By identifying gaps between provision of services and users’ needs we can suggest adjustments of the long-term care services and advance their development.Method The data from the first Slovenian national survey of social homecare (SHC) users and their informal carers was utilised. Linear regression analysis was used to evaluate factors that affect assessments of five-dimensional concept of access.ResultsOn average, affordability was rated the lowest (mean=2.9) and acceptability the highest (4.0), with availability, accessibility and accommodation (mean=3.6) in the middle. Regression analysis explains 15% of variability in affordability, while for other dimensions much less. Caregiver’s needs are the most influential predictor of access, negatively influencing the rating of access (availability B=.127, accommodation B=-.113, acceptability B=-.120, affordability B=-.155). Care recipients’ needs also affect the rating of affordability (B=-.132). Family income negatively influences the rating of availability (B=-.115), accessibility (B=-.076) and affordability (B=-.270). Residents of rural areas rate availability (B=-.070) and affordability (B=-.067) less favourable.DiscussionThis study showed that affordability is rated the least favourable among components of access. Adjustment in private out-of-pocket co-payment mechanism is suggested.

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Section: Discussionsupporting

confidence: 60%

Evaluation of access to long-term care services for old people ageing in place in Slovenia

Hlebec

2018

Slovenian Journal of Public Health

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“…There are also distinct differences in the accessibility of services for persons in the institutional care and persons in homecare as well as high regional differences in the availability of these services. Furthermore, the estimated number of people with severe unmet needs suggests that there are significant opportunities for social policy changes and development of new public and private services for older people in need, as well as for the integration of fragmented LTC (Hlebec, 2016a). These statements confirm the ascertainment that there exists a need for development of additional type of the formal homecare services for the elderly in Slovenia.…”

Section: Discussionmentioning

confidence: 62%

“…The authors have proclaimed informal care to be the most wide-spread form of care for the older people in Slovenia. In contrast, another study by Hlebec et al (2016a) revealed that, despite the efforts toward care for dependent elderly in Slovenia, there are still a proportion of older people with several needs for care, which are being unmet. Furthermore, the research by Hlebec et al (2014) showed that municipalities in Slovenia differ dramatically in the availability of care for the older people.…”

Section: Introductionmentioning

confidence: 94%

“…Moreover, the proportion of individuals aged 80 and more is expected to almost triple, from 4% in 2004 to 11.4% in 205011.4% in (OECD, 2013. Eurostat data also indicate that in 2011 26.6% of the population aged between 65 and 74 as well as 35.4% of the population aged 75 and over reported strong limitations in activities of daily living, while about 6.7% of them are reported to receive long-term care (LTC) (EU-SILC survey as cited in Hlebec et al, 2016a).…”

Section: Introductionmentioning

confidence: 99%

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Homecare Service Providers as an Organizational Form of Support for the Elderly: Establishment and Planning of Optimal Capacity

2017

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Background and Purpose: Different studies have highlighted health care allocation problems in Slovenia that indicate the increased need for homecare services for the elderly. It was also found that Slovenian municipalities differ dramatically in the availability of elder care services. A number of older people with diverse unmet needs for care remains. Therefore, the need for the establishment of an additional type of formal homecare services for the elderly exists. Design/Methodology/Approach: Although many positive effects of home elder care against institutional care are stressed in the literature, the results of many studies performed in recent years have indicated that accessibility of homecare for elderly in Slovenia remains scarce, and it is not equally accessible throughout the country. To mitigate this problem, a new organizational form called "elder homecare service provider" is indicated. The aim of the provider is to offer a variety of different services for the elderly (e.g. homemaking, social networking, transfer services, basic life needs, basic health services, etc.). The establishment of such an organization needs to be designed carefuly, while the unique characteristics and specific needs of the target population must be addressed to optimize desired outcomes. Results: The aim of the paper is to provide fundamental guidelines for the establishment of elder homecare service provider. All essential characteristics of such an organization are defined. To ensure an appropriate level of service quality, the primarly focus is oriented towards the planning of personnel team capacity. For this purpose, the service provider was described using the stochastic queueing model, which enables service capacity optimization considering different performance measures. The usefulness of the model was illustrated with a numerical example, which has shown that the results obtained provide valuable information for decision support. Conclusion:The establishment of a homecare service provider network would have many positive effects on society in general. The quality of the everyday life of the elderly is expected to be improved considerably, particularly in the rural areas where a lack of institutional care support is reported. Guidelines proposed in the paper together with the quantitave model for planning of its optimal capacity provide useful information, which are especially relevant in the preliminary phase of the establishment of service providers.

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“…Therefore, PC is often restricted to physical symptom relief in the terminal phase, including emergency visits by the GP, transfers and unplanned hospital admissions ( 11 ). Moreover, 4% of the elderly Slovenian population have severe limitations, for which they do not receive any care ( 12 ). Without a universally accepted definition of ‘early’ palliative care, the dilemma arises of marking the right moment to start anticipatory PC alongside or instead of disease-oriented care in the advanced stages of chronic diseases ( 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

Early identification of patients in need of palliative care in slovenian general practice

Klok

Engels

Veldhoven

et al. 2018

Slovenian Journal of Public Health

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BackgroundTo help general practitioners (GPs) in early identification of patients with palliative care (PC) needs, this pilot study aimed to determine the potential of the combined original surprise question (SQ1) (‘Would I be surprised if this patient died within the next 12 months?’) and the second surprise question (SQ2) (‘Would I be surprised if this patient was still alive after 12 months?’). We hypothesized that answering these SQs would trigger them to make a multidimensional care plan.Methods26 Slovenian GPs, randomized into 4 groups, were invited to write a care plan for each of the four patients described in case vignettes (2 oncologic, 1 organ failure and 1 frailty case). GPs in group 1 were only asked to write a care plan for each patient. GPs in group 2 answered SQ1 and GPs in groups 3 and 4 answered SQ1 and SQ2 before writing the care plan. The type and number of PC aspects mentioned in the respective care plans were quantified into a numeric RADboud ANTicipatory (RADIANT) score.ResultsMean RADIANT scores in groups 1-4 were 2.2, 3.6, 2.5 and 3.1, respectively. When comparing the different vignettes, vignette B (terminal oncologic patient) scored best (3.6). Mean RADIANT scores in groups 3 and 4 were slightly higher for GPs who would be surprised compared to GPs who would not be surprised if the patient was still alive in 12 months.ConclusionThe combined SQs were considered helpful in the early identification of patients in need of PC in Slovenian general practice.

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Determinants of Unmet Needs Among Slovenian Old Population

Cited by 18 publications

References 22 publications

Evaluation of access to long-term care services for old people ageing in place in Slovenia

Evaluation of access to long-term care services for old people ageing in place in Slovenia

Homecare Service Providers as an Organizational Form of Support for the Elderly: Establishment and Planning of Optimal Capacity

Early identification of patients in need of palliative care in slovenian general practice

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