Does informal care impact utilization of healthcare services? Evidence from a longitudinal study of stroke patients

Torbica, Aleksandra; Calciolari, Stefano; Fattore, Giovanni

doi:10.1016/j.socscimed.2014.11.005

Cited by 28 publications

(37 citation statements)

References 39 publications

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“…Studies have indicated that stroke survivors received 2.5–12.5 hr of informal care per week in the United States (Joo, Dunet, Fang, & Wang, ) and 20.2 hr per week in Europe (de Meijer, Brouwer, Koopmanschap, Berg, & Exel, ). However, as survivors gain more autonomy in their ADL, their formal and informal care needs decrease (Oliva‐Moreno et al, ; Torbica, Calciolari, & Fattore, ).…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…3 The support of the informal carer is often vital, playing a significant role in increasing the individual's access to health and rehabilitation services. 4 The 'burden' of providing informal care is considered to be the reduction in personal opportunities or actual health of an individual as a direct result of having to provide this unpaid support. 5 It has been previously identified that informal carers are likely to experience high levels of psychological distress 6 and a decline in physical health 7 and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Self-reported physical and mental health of Australian carers: a cross-sectional study

et al. 2016

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ObjectiveTo report on self-reported physical and mental health of informal carers in rural regions of New South Wales, Australia.MethodsA cross-sectional community-based sample (n=222) of carers completed a questionnaire incorporating self-reported measures of health from validated international instruments including Medical Outcomes Study Scale (SF-36), the Centre for Epidemiology-Depression (CES-D) and Kessler-10 (K-10) Psychological Distress Scales, along with information on participant demographics and other key caregiving characteristics such as health condition of care recipient.ResultsRural carers’ self-reported health was poor as evident on the SF-36 Physical and Mental Health component scores as well as each individual domain of the SF-36. Results from the CES-D and K-10 scores indicated very high rates of depressive symptoms and psychological distress. Over 70% of carers within the current study had CES-D scores indicative of depressive symptoms. Scores on the K-10 indicate almost half the carers were experiencing high levels of psychological distress, which is over 4 times the rate reported in the general Australian population.Conclusions and implicationsResults from this study were compared to Australian population normative data and were found to be significantly below Australian age-matched population norms for SF-36, CES-D and K-10. These findings illustrate the poor health profile of informal carers relative to the general Australian population, especially in terms of depressive symptoms and psychological distress. This highlights the need for additional support for rural carers in order to ease the accumulated mental and physical health burdens of this group.

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“…In these studies, informal care is found to be to some extent a substitute of formal care. Several recent studies by Weaver and Weaver (2014); Kim and Lim (2015); Torbica et al (2015) and Mommaerts (2018) confirm these results.…”

Section: Relationship Between Informal and Formal Carementioning

confidence: 54%

“…Cultural aspects are important drivers for the usage of formal and informal LTC. A number of studies report on the so-called North-South gradient in Europe (Bolin et al 2008;Bonsang 2009;Torbica et al 2015;and Barczyk and Kredler 2018). For example, Bolin et al (2008) provide evidence that in Southern European countries informal care plays a very important role, when compared to Central Europe.…”

Section: Socio-demographic Indicatorsmentioning

confidence: 99%

“…(Tomiak et al 2000) find that, after mental diseases, stroke is a major factor of entering a nursing home. The aftermath of cardio-vascular diseases is typically associated with a long rehabilitation process among survivors (Torbica et al 2015) and, therefore, yields higher utilization of care services. We could not find similar results in the case of bronchitis which is typically combined with other chronic obstructive pulmonary diseases (COPD).…”

Section: Regression Model For Dependencementioning

confidence: 99%

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Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach

Rudnytskyi

Wagner

2019

Risks

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Long-term care (LTC) encompasses a set of services provided to impaired and dependent elderly people. To assess the level of the dependence several scales are used, including activities of daily living (ADL), instrumental ADL (IADL) and functional limitations. Once an elderly person fails to perform these activities independently, he or she requires special assistance. Help can be provided as informal care by relatives and as formal care by professionals. The aim of this research is to study individual characteristics that relate to the demand of LTC and to analyze the relation between formal and informal care. We base our study on data from the Swiss Health Survey focusing on respondents aged over 65 years. Using the structural equation modeling technique, we develop a statistical model that considers the dependence concept as a latent variable. This hidden dependence variable combines three indices linked to the limitations in ADL, in IADL and functional limitations. Accounting for causality links between covariates enables us to include the indirect effect of pathologies on the receipt of LTC mediated via dependence. In our model, we do not assume a causal relationship between formal and informal care. From our results, we observe a significant impact of pathologies as well as of the socio-demographic factors on the demand for LTC. The relationship between formal and informal care is found to be of both a complementary and substitutional nature.

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Does informal care impact utilization of healthcare services? Evidence from a longitudinal study of stroke patients

Cited by 28 publications

References 39 publications

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

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

Self-reported physical and mental health of Australian carers: a cross-sectional study

Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach

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