Home Support Services in Ireland: Exchequer and Distributional Impacts of Funding Options

Keane, Claire; Lyons, Seán; Regan, Mark M.; Walsh, Brendan M.

doi:10.26504/sustat111

Cited by 1 publication

(2 citation statements)

References 16 publications

(23 reference statements)

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“…These could reflect greater needs, or better access to homecare and there is detailed evidence of insufficient and unequal homecare access for older populations in Ireland. 30,31 Home including home of relative/friend. Plus, a small number of patients were living in a nursing/residential home full-time and for these patients, nursing/residential home was interpreted as 'home'.…”

Section: Key Lessonsmentioning

confidence: 99%

“…This is further supported by the finding that older patients were significantly less likely to achieve congruence consistent with known gaps and inequalities in community-based supports for older people. 30,31,34 -Thus, while these patterns are likely capturing unobserved needs to some extent, when taken altogether they also consistently point to under-resourced community-based supports for older people in Ireland and it is likely that both factors are at play. These findings further strengthen the call for progress in Irish policy reforms to enhance community-based care.…”

Section: Key Lessonsmentioning

confidence: 99%

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Place of Death for Adults Receiving Specialist Palliative Care in Their Last 3 Months of Life: Factors Associated With Preferred Place, Actual Place, and Place of Death Congruence

Smith,

Brick,

Johnston

et al. 2024

J Palliat Care

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Objectives: Congruence between the preferred and actual place of death is recognised as an important quality indicator in end-of-life care. However, there may be complexities about preferences that are ignored in summary congruence measures. This article examined factors associated with preferred place of death, actual place of death, and congruence for a sample of patients who had received specialist palliative care in the last three months of life in Ireland. Methods: This article analysed merged data from two previously published mortality follow-back surveys: Economic Evaluation of Palliative Care in Ireland (EEPCI); Irish component of International Access, Rights and Empowerment (IARE I). Logistic regression models examined factors associated with (a) preferences for home death versus institutional setting, (b) home death versus hospital death, and (c) congruent versus non-congruent death. Setting: Four regions with differing levels of specialist palliative care development in Ireland. Participants: Mean age 77, 50% female/male, 19% living alone, 64% main diagnosis cancer. Data collected 2011-2015, regression model sample sizes: n = 342-351. Results: Congruence between preferred and actual place of death in the raw merged dataset was 51%. Patients living alone were significantly less likely to prefer home versus institution death (OR 0.389, 95%CI 0.157-0.961), less likely to die at home (OR 0.383, 95%CI 0.274-0.536), but had no significant association with congruence. Conclusions: The findings highlight the value in examining place of death preferences as well as congruence, because preferences may be influenced by what is feasible rather than what patients would like. The analyses also underline the importance of well-resourced community-based supports, including homecare, facilitating hospital discharge, and management of complex (eg, non-cancer) conditions, to facilitate patients to die in their preferred place.

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Section: Key Lessonsmentioning

confidence: 99%

Section: Key Lessonsmentioning

confidence: 99%