Reductions in local government spending on community-based social care and unmet social care needs of older people in England

Iparraguirre, José Luis

doi:10.1016/j.jeoa.2017.07.001

Cited by 14 publications

(12 citation statements)

References 30 publications

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“…Now it can be seen that the reverse is not true: in particular, a reduction in publicly funded care does not increase the probability of obtaining informal help. This is important because it would indicate that a contraction in adult social care budgets would manifest in higher unmet care needs among the older population (Iparraguirre, 2017).…”

Section: Resultsmentioning

confidence: 99%

Household composition and the dynamics of community-based social care in England

Iparraguirre

2019

Ageing and Society

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AbstractLittle is known about the dynamic relationship between the different funding sources of community-based social care in England. Using Waves 2–6 (2004–2013) of the English Longitudinal Study of Ageing survey, I estimated dynamic multi-level cross-classified mixed-effects logistic regression models to investigate whether receiving services by one source is more or less likely if an older person was already receiving services funded by the same source or another in the previous period. Four hypotheses between formal privately and publicly funded help and informal help are tested: substitution, complementarity, compensation and task-specificity. I also report evidence that older people on low incomes residing in local authorities that reduce social care spending are especially affected.

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Section: Resultsmentioning

confidence: 99%

Household composition and the dynamics of community-based social care in England

Iparraguirre

2019

Ageing and Society

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“…However, impacts on carers have hitherto been neglected. [11][12][13] Our study examined the extent to which LA ASC spending affects the subjective well-being of unpaid carers. Carers' well-being is an explicit focus of the Care Act 2014, vital for the operation of England's care system, and has implications for future demand for ASC.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Longitudinal analysis of local government spending on adult social care and carers’ subjective well-being in England

2021

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ObjectivesReform of England’s social care system is repeatedly discussed in the context of increasing demand, rising costs and austere policies that have decreased service provision. This study investigates the association between unpaid carers’ subjective well-being and local government spending on adult social care (ASC).Setting and participantsOur sample consists of 110 188 observations on 29 174 adults in England from the 2004–2007 British Household Panel Survey and the 2009–2018 UK Household Longitudinal Study. The data on local authorities’ spending on ASC where participants live is derived from the publications Personal Social Care Expenditure and Unit Costs (2004–2016); and ASC Activity and Finance Report England (2016–2018).Outcome measuresSubjective well-being is measured by the 12-item version of the General Health Questionnaire (GHQ-12) and 12-item version of the Mental Component Summary (MCS-12). We applied fixed-effects linear models to investigate the moderating effect of ASC spending on the association between subjective well-being and caring, controlling for a range of socioeconomic and demographic variables.ResultsCarers have a lower level of subjective well-being compared with non-carers, evident in their higher average GHQ-12 Likert score (β=2.7277 95% CI 0.2547 to 5.2008). Differences in the subjective well-being of carers and non-carers decrease with local government spending on ASC. Subjective well-being for carers was at a similar level to that of non-carers in high ASC spending local authorities (GHQ-12: −0.0123 95% CI −0.2185 to 0.1938, MCS-12: 0.0347 95% CI −0.3403 to 0.4098) and lower in other areas (GHQ-12: 0.1893 95% CI 0.0680 to 0.3107, MCS-12: −0.2906 95% CI –0.5107 to −0.0705). The moderating effect of ASC spending is found among people who care for 35+ hours per week.ConclusionGovernment spending on ASC protects unpaid carers’ well-being, and people providing more than 35 weekly hours of unpaid care are more likely to benefit from the current social care system.

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“…Failure to obtain sufficient assistance creates unmet needs among disabled older people. In developed countries, having unmet needs has become a common problem with deinstitutionalization across a range of care services [ 1 , 2 , 3 , 4 ]. Notwithstanding the differences in welfare systems, there is congruence across the fact that unmet needs continue to escalate among disabled older people in developing countries where traditional informal care dominates without a non-institution reform of care services [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence from recent research shows that as needs for elderly care increase and public spending tightens, the unmet needs among disabled older people grows [ 1 , 4 ]. However, it is apparent that no unanimous conclusion can be drawn in the causes or correlating research, despite the consensus on the prevalence of unmet needs among disabled older people.…”

Section: Introductionmentioning

confidence: 99%

Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective

Gao

Xie

et al. 2021

IJERPH

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One of the challenges in response to population aging is to meet needs for elderly care among older people especially for those who want to age in their homes or communities. However, disabled older people have more challenges due to their restricted mobility to access care resources than non-disabled ones. We propose a new framework based on the changing relationship between older people and their environment, in which resource linkage in elderly care utilization is emphasized. We conducted a survey with 139 participants (i.e., older people age 60 years or over with different level of disabilities) in three types of neighborhoods in Beijing, China. By conducting a decision tree analysis under the Person-Environment Link (P-E Link) model, we (1) characterized unmet needs for elderly care (activities of daily living (ADL) and instrumental activities of daily living (IADL) assistance) among community-dwelling disabled older people; (2) found disabled older people had more unmet needs for both ADL and IADL assistance because of a lack in linkages to care resources than non-disabled ones; and (3) characterized the linkages to care resources for better supporting disabled older people to age in place, including family support, social connection, and spatial environment. Our findings help improve the Anderson behavioral model by characterizing enabling environments, which highlights that not only the availability of enabling resources but also linkages to these enabling resources play an important role in meeting needs for care among disabled older people. Our findings can also inform improvements in policy design that are targeted to reduce elderly care inequalities.

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Reductions in local government spending on community-based social care and unmet social care needs of older people in England

Cited by 14 publications

References 30 publications

Household composition and the dynamics of community-based social care in England

Household composition and the dynamics of community-based social care in England

Longitudinal analysis of local government spending on adult social care and carers’ subjective well-being in England

Understanding the Unmet Needs among Community-Dwelling Disabled Older People from a Linkage Perspective

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