Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Lee, Tae Wha; Kovner, Christine; Mezey, Mathy; Ko, Il Sun

doi:10.1046/j.1525-1446.2001.00443.x

Cited by 24 publications

(16 citation statements)

References 26 publications

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“…Population-based studies for other disease site cohorts are required to examine similarities and differences in utilization and associated costs 14,16,20,[22][23][24][25][26][27] . The data source was administrative data from Ontario, which may not contain all variables of interest regarding home care utilization.…”

Section: Discussionmentioning

confidence: 99%

Population-Based Home Care Services in Breast Cancer: Utilization and Costs

et al. 2012

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Objective: To determine utilization and costs of home care services (HCS) for individuals with a diagnosis of breast cancer (BC). Methods: Incident cases of invasive BC in women were extracted from the Ontario Cancer Registry (2005–2009) and linked with other Ontario health care administrative databases. Control patients were selected from the population of women never diagnosed with any type of cancer. The types and proportions of HCS used were determined and stratified by disease stage. Attributable home care utilization and costs for BC patients were determined. Factors associated with HCS costs were assessed using regression analysis. Results: Among the 39,656 BC and 198,280 control patients identified (median age: 61.6 years for both), 75.4% of BC patients used HCS (62.1% stage I; 85.7% stage II; 94.6% stage III; 79.1% stage IV) compared with 14.6% of control patients. The number of HCS used per patient–year were significantly higher for the BC patients than for the control patients (14.97 vs. 6.13, p < 0.01), resulting in higher costs per patient–year ($1,210 vs. $325; $885 attributable cost to BC, p < 0.01). The number of HCS utilized and the associated costs increased as the BC stage increased. In contrast, HCS costs decreased as income increased and as previous health care exposure decreased. Interpretation: Patients with BC used twice as many HCS, resulting in costs that were almost 4 times those observed in a matched control group. Less than an additional $1000 per BC patient per year were spent on HCS utilization in the study population.

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Section: Discussionmentioning

confidence: 99%

Population-Based Home Care Services in Breast Cancer: Utilization and Costs

et al. 2012

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“…Este perfil se corresponde con el encontrado, por ejemplo, en Estados Unidos, donde los servicios de home care atienden a personas con un deterioro cognitivo y funcional menor que los centros residenciales (Lee, Kovner, Mezey y Ko, 2001), a diferencia de otros países donde las agencias de cuidado a domicilio proporcionan atención a personas con mayores niveles de dependencia (Kim, Cho y June, 2006).…”

Section: Servicio De Ayuda a Domicilio (Sad)unclassified

“…Estos factores pueden agruparse en tres categorías (Lee et al, 2001): sociodemográficos, relacionados con la salud y el estado físico y cognitivo, y vinculados al apoyo social.…”

Section: Residencias (R)unclassified

“…Factores sociodemográficos: ser mujer, carecer de cónyuge, no tener hijos, tener una edad avanzada (Luppa et al, 2010), ser de raza blanca (frente a hispano o afroamericano) y tener un nivel socioeconómico bajo (IMSERSO, 2015;Lee et al, 2001;Lim, 2009;Noël-Miller, 2010 (Buys et al, 2013), y la presencia de deterioro cognitivo y demencia (Tomiak et al, 2000;Gaugler, Kane, Kane, Clay y Newcomer, 2003;Barucha et al, 2004;Damián et al, 2004;McCallum, Simons, Simons y Friedlander, 2005;Sabartés et al, 2009;Lim, 2009;;Lekuona y Calvo, 2010;Cohen-Mansfield y Wirtz, 2011;Maxwell et al, 2013;Almomani et al, 2014;Helvik et al, 2014) Gaugler et al, 2003;Ander, Hyer y Slack, 2007). A su vez, su probabilidad ingreso se incrementa cuando presentan problemas de conducta (Gaugler et al, 2000).…”

Section: Residencias (R)unclassified

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Asignación de servicios sociales a personas mayores: revisión y modelo de toma de decisiones

et al. 2018

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Resumen. Como consecuencia del envejecimiento de la población y la disminución del cuidado informal, las instituciones públicas deben asumir una mayor responsabilidad en la atención a las personas mayores, proporcionando servicios que respondan objetivamente a sus necesidades. El objetivo de este trabajo es: por una parte, analizar el perfil de las personas mayores usuarias de servicios sociales; y, por la otra, comprobar si existen clasificaciones, sistemas o instrumentos que guíen a los y las profesionales en el proceso de asignación. Se realizó una revisión sistemática en PsicINFO, Web of Science, Dialnet, CSIC y Teseo. Se seleccionaron 44 artículos. Se identificaron como variables predictoras del uso de servicios: la dependencia funcional, el deterioro cognitivo, la ausencia o escasez de apoyo social y la precariedad de la vivienda. No se hallaron sistemas que faciliten la asignación de servicios en función de perfiles específicos. A partir de las variables obtenidas, se propone un modelo de toma de decisiones que facilita el ajuste entre las necesidades de las personas mayores y las prestaciones de los servicios. IntroducciónEl envejecimiento de la población -y las transformaciones en las estructuras familiares que conllevan una menor disponibilidad para proporcionar apoyo informal-genera la necesidad de que las instituciones públicas asuman una mayor responsabilidad en el cuidado de las personas mayores.En España, en los últimos años, se ha producido un aumento significativo del número de plazas de servicios sociales (IMSERSO, 2017). El servicio con un mayor índice de cobertura es la teleasistencia (el 8,89 por ciento), seguido de la atención residencial (el 4,4 por ciento), el servicio de ayuda a domicilio (el 3,77 por ciento) y los Centros de Día (el 1,05 por ciento). No obstante, el crecimiento no se

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“…Yet, at the same time, there are marked differences between men and women with respect to marital status. Married older persons have approximately half the risk of nursing home admission as unmarried people (e.g., widowed, never married, divorced, and separated; Lee, Kovner, Mezey, & Ko, 2001). Although being aged ]85 years increases the probability of nursing home admission, age alone contributes little to increasing the chances of institutionalisation, whereas the effect of poverty status on nursing home admission has yielded inconsistent results (Lee et al, 2001).…”

Section: Factors Influencing Nursing Home Placementmentioning

confidence: 99%

Predictors of Nursing Home Admission: A Social Work Perspective

Lim¹

2009

Australian Social Work

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Institutionalisation of geriatric patients is a growing trend in ageing societies, such as Singapore. Earlier studies focused on the sociodemographic profile and attributes of nursing home residents and applications, but neglected to address the predictors of nursing home admission from a social work perspective. The present retrospective study identifies independent risk factors that predispose a patient to a nursing home discharge from a general rehabilitation ward in a community hospital in Singapore, with a multidisciplinary emphasis on clinical intervention. Factor analysis results reinforced findings that functional impairment and dementia are consistent predictors of nursing home admission. Multivariate logistic regression analysis showed that positive predictors of nursing home admission include older age, length of hospital stay, low socioeconomic status, dementia, and functional disability. Social work interventions include early referrals to the medical social worker, so that options for social and family support can be explored prior to deciding to place patients in a nursing home. Other interventions include suitable family therapy and counselling for patients and their families.Times are changing. The Green House Project is a new philosophy of care for nursing homes that originates from New York. Developed by Dr William Thomas, in the tradition of the Eden Alternative, it defies the traditional regard of nursing homes as a matter of last resort and advocates that nursing homes must become true communities where our elders can live life to the fullest extent possible (Thomas, 1996). These models advocate improving the lives of people already living in nursing homes; however, a more critical issue at hand would be the appropriate assessment and placement of older persons in nursing homes. Nursing homes have typically been Correspondence to:

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Factors Influencing Long‐Term Home Care Utilization by the Older Population: Implications for Targeting

Cited by 24 publications

References 26 publications

Population-Based Home Care Services in Breast Cancer: Utilization and Costs

Population-Based Home Care Services in Breast Cancer: Utilization and Costs

Asignación de servicios sociales a personas mayores: revisión y modelo de toma de decisiones

Predictors of Nursing Home Admission: A Social Work Perspective

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