Distribution of Informal and Formal Home Help for Elderly People in Sweden

Herlitz, Claes

doi:10.1093/geront/37.1.117

Cited by 23 publications

(32 citation statements)

References 22 publications

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“…Factors previously reported to be predictive for the overall utilisation of home help in Sweden (Thorslund et al . 1991, Herlitz 1997, Sundstöm & Hassing 2000, Larsson & Thorslund 2002) also determined the amount of services allocated to recipients.…”

Section: Discussionmentioning

confidence: 99%

“…The vast majority of previous empirical investigations in different countries have assessed predictors of the use versus non‐use of home‐based services. Various need indicators have consistently been associated with the use of in‐home services (Herlitz 1997); for example: worse general health (Stoddart et al . 2002); dependence in activities of daily living (ADLs) or in instrumental ADLs (IADLs) (Thorslund et al .…”

Section: Introductionmentioning

confidence: 99%

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According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area of Sweden

Meinow

Kåreholt

Lagergren

2005

Health Soc Care Community

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Given the cutbacks which have been carried out in the Swedish welfare state despite the unchanged official policy of allocation of home help services according to needs, it is essential to evaluate the factors which guide the allocation of home help today. Whereas numerous studies have identified factors which predict entry into the home help system, the present paper concentrates on predictors of the amount of home help amongst those allocated assistance. Data were obtained from the population-based care and services section of the 2002 Swedish National Study of Aging and Care-Kungsholmen (SNAC-K). All home help recipients (> or = 65 years of age) living in an inner city district of Stockholm (Kungsholmen) were analysed with ordinary least squares regressions to identify predictors of the number of hours of home help (n = 943). Need indicators, i.e. dependency in activities of daily living (ADLs) and instrumental ADLs (IADLs), and cognitive impairment (Berger scale) were the strongest predictors of more hours of home help. The addition of sociodemographic (i.e. age, gender and income), environmental (i.e. informal care, housing adaptations and housing accessibility) and structural (i.e. variations in allocation decisions between one care manager and another) factors contributed only marginally to the explained variance. Hours of help entitlement increased slightly with greater age. Co-residing individuals were allocated significantly fewer home help hours than those living alone. Income and regular access to informal care were not significant predictors. The fact that services are provided according to need criteria does not necessarily mean that the provided services are adequate to meet needs. On the macro level, social policy decisions and available economic and manpower resources determine the allotment of municipal home help. However, this study in an urban sample suggests that, within the available resources, the amount of home help allocated is guided mainly by need indicators amongst those given assistance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area of Sweden

Meinow

Kåreholt

Lagergren

2005

Health Soc Care Community

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“…2003, Jenkins & Laditka 2003). Conversely, in two studies, being male was positively associated with an increase in caregiving by family members (Kemper 1992, Herlitz 1997); these two studies did not measure out‐of‐pocket expenditures.…”

Section: Discussionmentioning

confidence: 99%

“…1992, Tennstedt et al . 1993, Herlitz 1997, Houde 1998, Wilkins & Park 1998, Katz et al . 2000, Hall & Coyte 2001), and moreover, none considered the relationship between home‐based utilisation and costs.…”

Section: Introductionmentioning

confidence: 99%

Costs and determinants of privately financed home-based health care in Ontario, Canada

Guerriere

Wong

Croxford

et al. 2007

Health &Amp; Social Care in the Community

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The Canadian context in which home-based healthcare services are delivered is characterised by limited resources and escalating healthcare costs. As a result, a financing shift has occurred, whereby care recipients receive a mixture of publicly and privately financed home-based services. Although ensuring that care recipients receive efficient and equitable care is crucial, a limited understanding of the economic outcomes and determinants of privately financed services exists. The purposes of this study were (i) to determine costs incurred by families and the healthcare system; (ii) to assess the determinants of privately financed home-based care; and (iii) to identify whether public and private expenditures are complements or substitutes. Two hundred and fifty-eight short-term clients (<90 days of service utilisation) and 256 continuing care clients (>90 days of utilisation) were recruited from six regions across the province of Ontario, Canada, from November 2003 to August 2004. Participants were interviewed by telephone once a week for 4 weeks and asked to provide information about time and monetary costs of care, activities of daily living (ADL), and chronic conditions. The mean total cost of care for a 4-week period was $7670.67 (in 2004 Canadian dollars), with the overwhelming majority of these costs (75%) associated with private expenditures. Higher age, ADL impairment, being female, and a having four or more chronic conditions predicted higher private expenditures. While private and public expenditures were complementary, private expenditures were somewhat inelastic to changes in public expenditures. A 10% increase in public expenditures was associated with a 6% increase in private expenditures. A greater appreciation of the financing of home-based care is necessary for practitioners, health managers and policy decision-makers to ensure that critical issues such as inequalities in access to care and financial burden on care recipients and families are addressed.

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“…The selection and data collection processes concerning the elderly persons are described in greater detail elsewhere (9). A random sample of 1120 persons aged 80 years or more was selected from the SPAR register (national register of the total Swedish population).…”

Section: Sample and Questionnairementioning

confidence: 99%

Causes of Strain Affecting Relatives of Swedish Oldest Elderly

Herlitz

Dahlberg

1999

Scandinavian Caring Sciences

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We examined determinants of carer strain in a random sample of 170 relative of dependent elderly persons in Sweden aged 80 years or more. These persons were interviewed at home by means of the Sickness Impact Profile (SIP). Carer strain was assessed in interviews with carers who bore the main responsibility for care of an elderly relative. The response rate was 92%. Multiple logistic regression showed that cohabitation of carer and recipient was the sociodemographic variable most significantly associated with various stress factors and consequences or manifestations of stress; strain connected with ADL assistance given to the elderly person, strain arising from the elderly person's uncooperative or recalcitrant attitude or behaviour, worsening of the elderly-carer relationship, and encroachment on the carer's social life. Correlations between strain and various categories of physical and mental impairment were much lower, and in some respects were even negative. We conclude that support programs for relatives caring for dependent elderly persons should aim primarily at creating continuous relief for the carers and improving their opportunities for contact with other people generally.

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Distribution of Informal and Formal Home Help for Elderly People in Sweden

Cited by 23 publications

References 22 publications

According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area of Sweden

According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area of Sweden

Costs and determinants of privately financed home-based health care in Ontario, Canada

Causes of Strain Affecting Relatives of Swedish Oldest Elderly

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