Determinants of Unmet Needs Among Slovenian Old Population

Abstract

BackgroundPopulation ageing has significant effects on societies. The organization of care for dependent old people is one of the key issues for ageing societies. The majority of care for homebound dependent old people in Slovenia is still performed by informal carers, even though the use of formal services has been increasing over the last 20 years. The proportion and characteristics of people with unmet needs are important for the development of long term care social policy.MethodThe SHARE (Survey of Health, Ageing and Retirement in Europe) survey was used to assess the determinants of care arrangements and of unmet needs of the aging population in Slovenia. Multinomial regression analysis was used to evaluate individual and contextual determinants of care arrangements and unmet needs.ResultsThe proportion of older people with unmet needs is 4%. As expected, “needs” (Functional impairment OR=4.89, P=0.000, Depression OR=2.59, P=0.001) were the most important determinant, followed by the predisposing factor “age” (age OR 1.15, P=0.000) and two enabling factors, namely:”community setting and “availability of informal care within household” (Urban areas OR=.47, P=0.021; Household size 3+ OR=2.11, P=0.030).ConclusionThis study showed that there are a proportion of older people in Slovenia with severe needs for care, which are being unmet. As shown by the importance of enabling factors, social policy should encourage the development of formal services in rural areas and elaborate policy measures for informal carers.

Evaluation of access to long-term care services for old people ageing in place in Slovenia

“…Disparities which were observed between rural and urban settlements are not surprising, as they are observed in other countries as well ( 15 , 26 , 29 , 31 , 32 , 33 , 35 ). Financial constraints most likely enhance lower availability of services in rural areas and higher probability of having unmet needs ( 35 ). Informal care is related to the lack of financial resources, while the usage of formal services is often related to the financial status of care recipients and their families ( 34 ).…”

Homecare Service Providers as an Organizational Form of Support for the Elderly: Establishment and Planning of Optimal Capacity

“…There are also distinct differences in the accessibility of services for persons in the institutional care and persons in homecare as well as high regional differences in the availability of these services. Furthermore, the estimated number of people with severe unmet needs suggests that there are significant opportunities for social policy changes and development of new public and private services for older people in need, as well as for the integration of fragmented LTC (Hlebec, 2016a). These statements confirm the ascertainment that there exists a need for development of additional type of the formal homecare services for the elderly in Slovenia.…”

“…The authors have proclaimed informal care to be the most wide-spread form of care for the older people in Slovenia. In contrast, another study by Hlebec et al (2016a) revealed that, despite the efforts toward care for dependent elderly in Slovenia, there are still a proportion of older people with several needs for care, which are being unmet. Furthermore, the research by Hlebec et al (2014) showed that municipalities in Slovenia differ dramatically in the availability of care for the older people.…”

“…Moreover, the proportion of individuals aged 80 and more is expected to almost triple, from 4% in 2004 to 11.4% in 205011.4% in (OECD, 2013. Eurostat data also indicate that in 2011 26.6% of the population aged between 65 and 74 as well as 35.4% of the population aged 75 and over reported strong limitations in activities of daily living, while about 6.7% of them are reported to receive long-term care (LTC) (EU-SILC survey as cited in Hlebec et al, 2016a).…”

Early identification of patients in need of palliative care in slovenian general practice

“…Therefore, PC is often restricted to physical symptom relief in the terminal phase, including emergency visits by the GP, transfers and unplanned hospital admissions ( 11 ). Moreover, 4% of the elderly Slovenian population have severe limitations, for which they do not receive any care ( 12 ). Without a universally accepted definition of ‘early’ palliative care, the dilemma arises of marking the right moment to start anticipatory PC alongside or instead of disease-oriented care in the advanced stages of chronic diseases ( 13 , 14 ).…”