Developments in home-care use. Policy and changing community-based care use by independent community-dwelling adults in the Netherlands

Plaisier, Inger; Verbeek-Oudijk, Debbie; Klerk, Mirjam de

doi:10.1016/j.healthpol.2016.11.006

Cited by 23 publications

(28 citation statements)

References 20 publications

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“…Even more strikingly, the influence of social support (as measured by the mentioning of children, the risk for social isolation according to LSNS-6, and household composition) appears limited in the bivariable analysis, and disappears when adjusting for need factors. This is in contradiction with previous work [7,8,18,19,21,22,[27][28][29][30][31]33]. We can hypothesize that formal home care does not compensate for the lack of close relatives in our context, but rather carries out tasks that are not accomplished by informal carers anyway.…”

Section: Discussioncontrasting

confidence: 99%

“…Finally, literature is equivocal regarding the influence of low income on formal home care utilization, sometimes considering it an enabling factor, sometimes a hindering factor [7,8,17,23,28,29,34]. Our observations support the first hypothesis, since participants reporting a difficult financial situation were more prone to become users, even after adjusting for need factors.…”

Section: Discussionsupporting

confidence: 72%

“…This could indicate a variable effect of gender according to the local background. Regarding educational level, previous research was equivocal and our findings support an absence of effect [7,21,23,27,28,[30][31][32]. If culturally anchored attitudes are at work in our context, their existence is not supported by an association of incident home care utilization with the country of birth.…”

Section: Discussioncontrasting

confidence: 64%

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Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort

Dupraz

Henchoz

Santos-Eggimann

2020

BMC Health Serv Res

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Background: Given the increasing importance of formal home care services in policies dedicated to elder care, there is major interest in studying individuals' characteristics determining their utilization. The main objective of this research was to quantify, during a 6-year timeframe, home care use trajectories followed by community-dwelling participants in a cohort study of older adults. The secondary objective was to identify factors associated with home care utilization using Andersen's Behavioural Model of Health Services Use. Methods: We proceeded to an analysis of data prospectively collected in the setting of the Lc65+ populationbased study conducted in Lausanne (Switzerland). Self-reported utilization of professional home care in 2012 and 2018 was used to define trajectories during this timeframe (i.e. non-users, new users, former users and continuing users). Bivariable analyses were performed to compare new users to non-users regarding the three dimensions of Andersen's model (predisposing, enabling and need factors) measured at baseline. Then, binomial logistic regression was used in a series of two hierarchical models to adjust for need factors first, before adding predisposing and enabling factors in a second model. Results: Of 2155 participants aged between 69 and 78 in 2012, 82.8% remained non-users in 2018, whereas 11.2% started to use professional home care. There were 3.3% of continuing users and 2.7% of former users. New users exhibited a higher burden of physical and psychological complaints, chronic health conditions and functional limitations at baseline. After adjusting for these need factors, odds of home care utilization were higher only in participants reporting a difficult financial situation (OR 1.65, 95% CI 1.12-2.45). Conclusions: In the setting of a Swiss city, incident utilization of formal home care by older adults appeared to be largely determined by need factors. Modifiable factors like personal beliefs and knowledge about home care services did not play a role. After adjusting for need, odds of becoming home care user remained higher in participants reporting a difficult financial situation, suggesting such vulnerability does not hamper access to professional home care in this specific context.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 72%

Section: Discussioncontrasting

confidence: 64%

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Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort

Dupraz

Henchoz

Santos-Eggimann

2020

BMC Health Serv Res

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“…Given that the main focus of the current study is on the trend over time in the household provision by adult children of impaired older persons, we adopted a repeated cross-sectional design (Steel 2008; cf. Johansson, Sundström and Hassing 2003; Plaisier, Verbeek-Oudijk and De Klerk 2017). We estimated a series of multinomial regression models to predict adult children's occasional and frequent provision of household support to ageing parents.…”

Section: Methodsmentioning

confidence: 99%

“…Consequently, these services became less attractive, particularly for persons with higher incomes ( cf . Plaisier, Verbeek-Oudijk and De Klerk 2017).…”

Section: The Case Of the Netherlandsmentioning

confidence: 99%

Adult children stepping in? Long-term care reforms and trends in children's provision of household support to impaired parents in the Netherlands

2017

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Recent long-term care (LTC) reforms in the Netherlands are illustrative of those taking place in countries with a universalistic LTC model based on extensive provision of state supported services. They entail a shift from de-familialization, in which widely available state supported LTC services relieve family members from the obligations to care for relatives in need, to supported familialism, in which family involvement in caregiving is fostered through support and recognition for families in keeping up their caring responsibilities. Using data from four waves of the Netherlands Kinship Panel Study (n=2,197), we show that between 2002 and 2014 the predicted probability that adult children provide occasional household support to impaired parents rose substantially. Daughters more often provided household support to parents than did sons, but no increase in the gender gap over time was found. We could not attribute the increase in children's provision of household support to drops in the use of state supported household services. The finding that more and more adult children are stepping in to help their ageing parents fits a more general trend in the Netherlands of increasing interactions in intergenerational families.

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How regulatory frameworks drive differences in home‐care agencies: Results from a national multicenter cross‐sectional study in Switzerland

Möckli,

Wächter,

Moffa

et al. 2023

Health Planning & Management

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IntroductionThe sustainability and rising costs of the health‐care system are of concern. Although health‐care reforms impact various areas of care, there is only limited evidence on how regulations affect home‐care agencies and health‐care delivery.ObjectivesThe primary aim was to explore different financial and regulatory mechanisms and how they drive differences in the organizational structures, processes, and work environment of home‐care agencies.Design and methodsWe used data from a national multicenter cross‐sectional study of Swiss home care that included a random sample of 88 home‐care agencies with a total of 3223 employees. Data was collected in 2021 through agency and personnel questionnaires including geographic characteristics, financial and regulatory mechanisms, service provision, financing, work environment, resources and time allocation, and personnel recruitment. We first conducted a cluster analysis to build agency groups with similar financial and regulatory mechanisms. We then performed Fisher's exact, ANOVA, and Kruskal–Wallis tests to determine group differences in organizational structures, processes, and work environments. Finally, we performed a lasso regression to determine which variables were predictive for the groups.ResultsFour agency groups were built, differing in view of financial and regulatory mechanisms and we found differences in the range and amount of services provided, with regard to employment conditions and cost structures.DiscussionThe most prominent differences were found between agency groups with versus agency groups without a service obligation. Financial incentives must be well aligned with the goal of achieving and maintaining financially sustainable, accessible, and high‐quality home care.

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Developments in home-care use. Policy and changing community-based care use by independent community-dwelling adults in the Netherlands

Cited by 23 publications

References 20 publications

Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort

Formal home care use by older adults: trajectories and determinants in the Lc65+ cohort

Adult children stepping in? Long-term care reforms and trends in children's provision of household support to impaired parents in the Netherlands

How regulatory frameworks drive differences in home‐care agencies: Results from a national multicenter cross‐sectional study in Switzerland

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