Gender bias in public long-term care? A survey experiment among care managers

Jakobsson, Niklas; Kotsadam, Andreas; Syse, Astri; Øien, Henning

doi:10.1016/j.jebo.2015.09.004

Cited by 33 publications

(22 citation statements)

References 45 publications

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“…Consistent with this, research implies that home-based care yields positive effects for informal caregivers of cancer patients at their end-of-life [12]. Some studies find that care managers-who distribute the scarce resource of care among patients in municipalities-might discriminate against those that have access to informal care [55]. Under these circumstances, increased home-based care might actually have negative consequences for those who are dying and for the informal caregiver.…”

Section: Discussionmentioning

confidence: 91%

Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Bjørnelv

Edwin

Deb

et al. 2020

BMC Health Serv Res

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Background: Economic analyses of end-of-life care often focus on single aspects of care in selected cohorts leading to limited knowledge on the total level of care required to patients at their end-of-life. We aim at describing the living situation and full range of health care provided to patients at their end-of-life, including how informal care affects formal health care provision, using the case of colorectal cancer. Methods: All colorectal cancer decedents between 2009 and 2013 in Norway (n = 7695) were linked to six national registers. The registers included information on decedents' living situation (days at home, in short-or long-term institution or in the hospital), their total health care utilization and costs in the secondary, primary and home-and community-based care setting. The effect of informal care was assessed through marital status (never married, currently married, or previously married) using regression analyses (negative binominal, two-part models and generalized linear models), controlling for age, gender, comorbidities, education, income, time since diagnosis and year of death. Results: The average patient spent four months at home, while he or she spent 27 days in long-term institutions, 16 days in short-term institutions, and 21 days in the hospital. Of the total costs (~NOK 400,000), 58, 3 and 39% were from secondary carers (hospitals), primary carers (general practitioners and emergency rooms) and home-and community-based carers (home care and nursing homes), respectively. Compared to the never married, married patients spent 30 more days at home and utilized less home-and community-based care, but more health care services at the secondary and primary health care level. Their total healthcare costs were significantly lower (−NOK 65,621) than the never married. We found similar, but weaker, patterns for those who had been married previously. Conclusion: End-of-life care is primarily provided in the secondary and home-and community-based care level, and informal caregivers have a substantial influence on formal end-of-life care provision. Excluding aspects of care such as home and community-based care or informal care in economic analyses of end-of-life care provides a biased picture of the total resources required, and might lead to inefficient resource allocations.

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Section: Discussionmentioning

confidence: 91%

Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Bjørnelv

Edwin

Deb

et al. 2020

BMC Health Serv Res

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“…The wording of these supply-conditioned rights is different from the wording of the legal rights connected to short-term care obligations; instead of 'employee' and 'right', the words used are 'relative' and 'apply'. As a result, the availability of these schemes to carers is affected by other factors, such as municipal finances and the applicant's social network (Jakobsson, Kotsadam, Syse, & Øien, 2015;Rauch, 2007Rauch, , 2008. As of 2014, there are still few truly work-family facilitating schemes for eldercare provision in these countries.…”

Section: Discussionmentioning

confidence: 99%

Eldercare policies in Scandinavia between 1993 and 2014: Increased facilitation of family caregiving?

Martens

2018

Nordic Journal of Social Research

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This article asks whether legal rights provided through national legislation on services provision in Scandinavia have become, over time, more accommodating to the role of family caregiving to elderly relatives. The study is based on a comparison and analysis of changes in legislation between 1993 and 2014 in the three Scandinavian countries. It is limited to legislation on the right to eldercare services and on work-family facilitating policies in relation to the provision of care to an elderly relative. Work-family facilitating policies are those policies that enable the combining of employment in the formal economy with caring for family members without large prohibitive costs for the caregiver. The main findings in this article are that the Scandinavian countries strengthened the legal right to public care services between 1993 and 2014, but that there are few, if any, truly work-family facilitating policies. The existing schemes do not facilitate a combination of employment and care, but rather force the family caregiver to choose between them. The dilemma is whether to continue passively with a high, but declining, level of public service provision of eldercare, leaving unmet care needs to unpaid family carers, or to introduce work-family facilitating policies enabling remunerated family care in addition to extensive public services provision.

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“…Hence, there is empirical support for claims of offsprings to play a role for care provision of older parents in need. Even in Norway where there are no filial obligations to support parents in need, empirical studies demonstrate that care managers do actually consider presence and proximity of kin when allocating care services (Jakobsson et al 2016).…”

Section: Linked Lives and Support In Late Adulthoodmentioning

confidence: 99%

Knitting alone – in the city – ageing and kinship availability as a vulnerability marker

Sugahara

Nordvik

2020

Nordic Social Work Research

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A basic premise underlying this article is that the social surroundings of individuals as they gradually age are not homogeneous and have influence on their well-being. Furthermore, if significant variation on the social context are found, they should also affect and be taking into account on the provision of different kinds of public welfare support. This paper analyses two particularly relevant variables influencing this context, location and family availability. We ask if a focus on head count demographics hide important aspects of the challenges posed upon welfare agencies when preparing for and undertaking social work in practice. In order to illustrate the magnitude of those differences we study the population composition in three regions in Norway: The municipality of Oslo, Akershus county and Helgeland. We combine population registers with a parent child identifier, which enables us to map the older person's spousal situation, presence and location of children (and grandchildren), what we term life links adjusted shares. The results revealed that the female surplus in the older population is far stronger in Oslo than in the two other regions considered. Moreover, the combination of a higher prevalence of older people not residing together with a spouse, older people without children, and older peoples with fewer children, place Oslo's older residents in a relatively more vulnerable position in terms of spouse and kinship availability. Hence, we will claim that there is a need for an increased attention to not only head count demographics, but also to the uneven geographic distribution of life links.

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Gender bias in public long-term care? A survey experiment among care managers

Cited by 33 publications

References 45 publications

Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Till death do us part: the effect of marital status on health care utilization and costs at end-of-life. A register study on all colorectal cancer decedents in Norway between 2009 and 2013

Eldercare policies in Scandinavia between 1993 and 2014: Increased facilitation of family caregiving?

Knitting alone – in the city – ageing and kinship availability as a vulnerability marker

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