The Role of Disability in Explaining Long-Term Care Utilization
| Autor: | Eddy van Doorslaer, Xander Koolman, Marc A. Koopmanschap, Claudine de Meijer |
|---|---|
| Přispěvatelé: | Health Economics (HE), Applied Economics, Health Economics and Health Technology Assessment, APH - Quality of Care |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Gerontology
Male Aging Activities of daily living Cross-sectional study MEDLINE Service use Sex Factors Sex factors Elderly population Activities of Daily Living Medicine Homes for the Aged Humans Disabled Persons Geriatric Assessment Aged Netherlands Aged 80 and over business.industry Public Health Environmental and Occupational Health Age Factors Geriatric assessment Middle Aged Home Care Services Long-Term Care Nursing Homes Long-term care Cross-Sectional Studies Female business |
| Zdroj: | Medical Care, 47(11), 1156-1163. Lippincott Williams & Wilkins de Meijer, C A M, Koopmanschap, M A, Koolman, A H E & van Doorslaer, E 2009, ' The Role of Disability in Explaining Long-Term Care Utilization ', Medical Care, vol. 47, no. 11, pp. 1156-1163 . https://doi.org/10.1097/MLR.0b013e3181b69fa8 Medical Care, 47(11), 1156-1163. Lippincott Williams and Wilkins |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/MLR.0b013e3181b69fa8 |
| Popis: | In view of aging populations, it is important to improve our understanding of the determination of long-term care (LTC) service use among the middle-aged and elderly population. We examined the likelihood of using 2 levels of LTC-homecare and institutional care-in the Netherlands and focused on the influence of the measured degree of disability.We pooled 2 cross-sectional surveys-one that excluded institutionalized and one that was targeted at institutionalized individuals aged 50+. Disability is measured by impairment in (instrumental) activities of daily living (iADL, ADL) and mobility. Consistency with official Dutch LTC eligibility criteria resulted in the selection of an ordered response model to analyze utilization. We compared a model with separate disability indicators to one with a disability index.Age and disability, but not general health, proved to be the main determinants of utilization, with the composite index sufficiently representing the disaggregated components. The presence of at least 1 disability displayed a greater effect on utilization than any additional disabilities. Apart from disability and age, sex, living alone, psychologic problems, and hospitalizations showed a significant influence on LTC use. Some determinants affected the likelihood of homecare or institutional care use differently.Even after extensive control for disability, age remains an important driver of LTC use. By contrast, general health status hardly affects LTC use. The model and disability index can be used as a policy tool for simulating LTC needs. |
| Databáze: | OpenAIRE |
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