Urban-rural differences in intention to age in place while receiving home care services: Findings from the National Survey of Older Koreans

Huang

et al. 2022

Preprint

Background: China has the highest number of older adults with disabilities worldwide. Home and community-based services (HCBSs) are optimal ways to deal with disability problems. Studies have shown urban-rural disparities in the supply and demand of HCBSs in China and that disability levels are significantly associated with HCBSs utilization. However, what’s inconspicuous is whether there are urban-rural disparities in HCBSs utilization and whether HCBSs utilization and levels of disabilities are associated. This study is designed to analyze urban-rural disparities both in HCBSs utilization and in the relationship between HCBSs utilization and levels of disabilities among Chinese older adults with disabilities. Methods: In applying the Andersen behavioral model, bivariate analysis and multivariate regression models were employed using data from 843 older adults with disabilities from the 2018 China Longitudinal Aging Social Survey. Results: Urban older adults with disabilities used HCBSs over twice as often as their rural counterparts. Furthermore, older adults with moderate disabilities living in urban areas used HCBSs more than twice as often as older adults with mild disabilities, while older adults with severe disabilities residing in urban areas used HCBSs approximately three times more often than older adults with mild disabilities. However, regarding rural older adults with disabilities, the levels of disabilities were unrelated to HCBSs utilization. Conclusion: Disability levels among Chinese older adults with disabilities were significantly correlated with HCBSs utilization throughout the country and in urban areas, but not in rural areas. The underlying reason for these disparities is the low utilization of HCBSs in rural areas among older adults with disabilities. The government should combine the supply-side and demand-side perspectives to fundamentally address urban-rural disparities in using HCBSs among Chinese older adults with disabilities.

Section: Discussionmentioning

confidence: 62%

Urban-rural disparities in the association between home and community-based services utilization and levels of disabilities among Chinese older adults with disabilities

Huang

et al. 2022

Preprint

“…It may be related to the specific characteristics of community home care. Spouses are also considered part of non-professional nursing care, which includes both emotional and practical support ( 25 , 26 ). Although older adults can have a rich and colorful retirement life in the daytime, the loss of the spouse’s companionship, and the night loneliness will double the widowed older adults.…”

Section: Discussionmentioning

confidence: 99%

Factors related to satisfaction with community-based home aging services in Shandong, China

Wang,

Zhang,

Huang

et al. 2024

Front. Public Health

PurposeThis study investigated the satisfaction of current community-based home care services and its factors in adults aged ≥60 years.MethodsUsing stratified cluster random sampling, we surveyed 1,494 older adults in Jinan and Qingdao, Shandong province, between 2021 and 2023. The baseline and satisfaction surveys were designed by our research team, and the questionnaires were conducted in the form of structured interviews. Kruskal-Wallis H-test and Logistic regression analysis were used to explore the influencing factors of satisfaction.ResultsThe satisfaction was mainly affected by age (p = 0.007), marital status (p < 0.001), pre-retirement occupation (p = 0.003), economic source (p < 0.001), and mode of residence (p = 0.001) in the study of 1,494 older adults. Under the influence of multiple factors, the evaluation of older adults services, married [OR = 4.039, 95% CI: 1.176–13.877] were more inclined to be average, and their occupations were agriculture, forestry, animal husbandry, fishery, and water production workers [OR = 0. 237, 95% CI: 0.068–0.819] and production and transportation equipment operators and related personnel [OR = 0.153, 95% CI: 0.024–0.966] or [OR = 0.153, 95% CI: 0.029–0.820] tended to be more dissatisfied.ConclusionThe satisfaction level of community-based home care services is relatively high among older adults, and it is mainly affected by factors such as age, marital status, pre-retirement occupation, source of financial resources, and mode of residence. Addressing the emotional needs of older adults, lowering the cost of aging, and integrating health care and aging seamlessly are among the ongoing challenges that we need to tackle.

“…The result indicates that services provided by hospitals may vary by area. In metropolitan areas and large cities, primary healthcare and social welfare resources are more abundant [28], suggesting that the appropriate services for discharged patients can be readily available. Therefore, further studies should be conducted on the differences in patient support services by regional area.…”

Section: Discussionmentioning

confidence: 99%

Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service – Senior Cohort Data

Hwang,

2023

JPMPH

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services.Methods: To apply transitional care services that are compatible with Korea’s circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service’s Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days.Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41).Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.