Individual characteristics associated with utilization of nursing care in very old population: cross-sectional study

Abstract

Background: Older adults aged 80 or older belong to the most frequent recipient of nursing care. Since this age group remains often underrepresented in previous research, little is known about the characteristics associated with utilization of nursing care services. Therefore, the aim of this study was to examine individual (predisposing, enabling, and need) predictors of nursing care utilization in very old population of North Rhine-Westphalia (NRW). Methods: Using data from a representative cross-sectional study, 1,531 community-dwelling and institutionalized individuals aged ≥80 years were included. The use of outpatient care services, day care, private and inpatient nursing care was considered. Multinomial regression was applied to investigate the factors explaining nursing care use in very old adults. Results: Overall, 69.9% of participants used no nursing care services, 21.9% were using outpatient/day and/or private care, and 8.2% were institutionalized. Compared to very old adults who did not use any nursing care services, users of outpatient/day and/or private care had higher likelihood of being older, having no partner, and experiencing higher functional and cognitive disability. Comparing non-users with those using inpatient nursing care, institutionalized individuals were more likely older, had lower socioeconomic status, were childless and not in partnership, socially isolated, felt more likely lonely, were more functional and cognitive impaired, but they experienced less likely five or more chronic conditions, and were less likely physically pre-frail and frail. Conclusions: Individual need factors (referring to health status) dominated in explaining utilization of outpatient/day and/or private care, suggesting that very old population in NRW may have equitable access to these services. Since social structure, region, and social resources explained who have received inpatient nursing care, this kind of care might be inequitable accessible to very old adults in NRW. Nevertheless, the results indicate that nursing homes could substitute the role of missing closest relatives as potential caregivers, prevent frailty and multimorbidity, but fail to ensure social inclusion of the oldest-old within facilities.