Factors influencing the use of community health and social services by those aged 65 and over

Boniface, David; Denham, M. J.

doi:10.1111/j.1365-2524.1997.tb00098.x

Cited by 7 publications

(3 citation statements)

References 12 publications

(14 reference statements)

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“…There was little or no evidence of any variation in use of primary care by socioeconomic group, after adjusting for differential need, in 9 of the 13 studies ( Table 3). They originated from Australia, Ireland, New Zealand, the United Kingdom, and the majority of the OECD countries in van Doorslaer and colleagues' paper (10,11,13,17,23,24). Two studies from the United Kingdom and the Netherlands and analysis of panel data from Greece, Spain, and Germany described higher use of primary care by lower socioeconomic groups (15,16,24).…”

Section: Primary Care Servicesmentioning

confidence: 99%

How Close Have Universal Health Systems Come to Achieving Equity in Use of Curative Services? A Systematic Review

Hanratty

Zhang²,

Whitehead³

2007

Int J Health Serv

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Most governments in established market economies have developed universal systems of health care, but these are being increasingly threatened by widespread health sector reforms. Hence, it is more important than ever to monitor the effects of policy changes on the ability of universal systems to achieve their equity goals. This article provides evidence for such monitoring. The authors present the results of a systematic review of equity in use of curative health services in universal systems, together with a critical appraisal of the essential components of studies to address this question. Of the 79 studies identified that addressed the review question, only 26 met the inclusion criteria and adjusted for differential health need across socioeconomic groups. The authors found a pro-rich bias in use of specialist hospital services and a reasonably equitable access to primary health care by different socioeconomic groups. There was a wide inter-study variation in the difference in utilization rates between people of high and low socioeconomic groups. Improvements are needed in the way that equity in universal systems is monitored, with particular attention to how "need" is defined and to the impact on patients of indirect costs.

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Section: Primary Care Servicesmentioning

confidence: 99%

How Close Have Universal Health Systems Come to Achieving Equity in Use of Curative Services? A Systematic Review

Hanratty

Zhang²,

Whitehead³

2007

Int J Health Serv

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“…For the general population, for example, Wilson (1994) suggests that support services of the types older people want are not widely available, and that services which are available are not very appealing. Bowling et al (1993), OPCS (1996) and Boniface and Denham (1997) establish that many older people with significant levels of disability are not using services and MacDonald (1999) identifies cases of non‐use of services related to views about their inappropriateness. Scharf et al (2004) demonstrate the negative impact of poverty on service access and use for older people.…”

Section: Support At Home For Older Peoplementioning

confidence: 99%

Mainstreaming Equality: Implications of the Provision of Support at Home for Majority and Minority Ethnic Older People

Bowes

2006

Soc Policy Adm

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This paper explores the potential impact and practical difficulties of mainstreaming equalities in support at home for minority and majority ethnic older people, drawing on two linked empirical research projects. Social care providers have long faced difficulties in catering for diversity of need. Recently, diversity within minority ethnic groups has increased, and there is now a statutory duty to promote equality. Research findings illustrate the complexity of exclusionary processes, with particular reference to the example of health care. There is a gap between the high-level commitment to mainstreaming equality and people's lived experiences. Autonomy and choice are central to community care legislation, policy and practice guidance, but in reality, the research shows that choices are limited for both minority and majority older people. More user-focused approaches and grassroots involvement may offer ways forward, despite some limitations of current models. In conclusion, the potentiality of a broad mainstreaming equality perspective is highlighted, but challenges include a need for a more grounded approach, better engagement with user groups and a need to focus on understanding issues of implementation.

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“…2002). In the UK, gender was significantly associated with use of home help, but not meals services or nursing (Boniface & Denham 1997). In the USA, those living alone were more likely to use transportation services (Alkema et al.…”

Section: Introductionmentioning

confidence: 99%

Assessing patterns of home and community care service use and client profiles in Australia: a cluster analysis approach using linked data

Kendig

Mealing

Carr

et al. 2011

Health &Amp; Social Care in the Community

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The planning and delivery of care systems require knowledge on the ways in which individuals access available services that are funded by a range of health and community services. The aims of this study were to identify distinct groups of Home and Community Care (HACC) clients in New South Wales, Australia, based on patterns of actual service use, and to understand the health and social needs and resources of client groups that access different mixes of services. Multiple data sets linked at the individual level - including the 45 and Up Study community survey, the HACC Minimum Data Set and the Admitted Patient Data Collection for hospitals - provide an innovative basis to investigate the complexity of access to service use. Data were collected between 2006 and 2008. A cluster analysis based on clients' type and volume of community service use was conducted on the 4890 HACC clients in the linked dataset and nine distinct clusters of clients were identified. Three of these clusters were considered 'complex', in terms of the range of community and hospital assistance received, while the others comprised mainly of one or two dominant service types. The analytical approach and findings developed here provide a client-centred approach to monitor and evaluate access to local service systems that are being reformed to better integrate the delivery of health and community services currently funded and managed separately by national and state governments.

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Factors influencing the use of community health and social services by those aged 65 and over

Cited by 7 publications

References 12 publications

How Close Have Universal Health Systems Come to Achieving Equity in Use of Curative Services? A Systematic Review

How Close Have Universal Health Systems Come to Achieving Equity in Use of Curative Services? A Systematic Review

Mainstreaming Equality: Implications of the Provision of Support at Home for Majority and Minority Ethnic Older People

Assessing patterns of home and community care service use and client profiles in Australia: a cluster analysis approach using linked data

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