Unravelling Hidden Inequities in a Universal Public Long-Term Care System

García-Gómez, Pilar; Hernández-Pizarro, Helena M.; Casasnovas, Guillém López i; Vidiella-Martin, Joaquim

doi:10.2139/ssrn.3329198

Cited by 2 publications

(2 citation statements)

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“…Kalwij et al (2013) also estimate longevity differences over income and gender using Dutch administrative data and report similar results to what we find. Similarly, a negative relationship between long-term care needs and long-term care use and socioeconomic status has been documented (Ilinca et al, 2017;Rodrigues et al, 2018;Garcia-Gomez et al, 2019;Tenand et al, 2020a). These findings align with the well-documented gender-health paradox, stating that women indeed do live longer but tend to be less healthy (Case and Paxson, 2005;Oksuzyan et al, 2008).…”

Section: Literaturesupporting

confidence: 73%

Health Risks in Old Age

van der Vaart

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Together with my father, I visited the Bachelor's Open Day of the University of Groningen in Autumn 2013 to learn more about the Econometrics & Operations Research program. I cherish great memories of my father's support, especially now, some ten years later, having completed this wonderful program and even my PhD thesis. On the rough path to obtaining my PhD, I have been blessed with two of the greatest sources of wealth: love and support from others. The supervision by Max, Raun, and Rob has been indispensable for my development as a researcher, but above all, as a person. We have known each other for about seven years now and much has happened in the meantime. I was first your research master student and thereafter your PhD candidate. The so many shared memories make me regularly realize: you have a special place in my heart. Many other colleagues have also provided me with much guidance and support. Gerard, we have known each other for years, and we worked together successfully on the final chapter of my dissertation. Jochen & Viola, you have meant much to me both in the fore-and background, thereby opening doors for me that would otherwise remain closed. Agnieszka, what many may not know is that you supervised my bachelor's thesis and, together with Raun, advised me to pursue a research master's degree. Orest, under your guidance, I have been able to develop as a teacher, a role that brings me great satisfaction. I am very grateful to you and the many other colleagues that have guided me in the right direction. In Spring 2022, I visited the University of Copenhagen. The stay taught me a lot about how other researchers work and what it is like to stand on my own feet. Søren, and everyone who is involved in the Center for Economic Behavior and Inequality (CEBI), your hospitality and help make me recommending anyone to visit CEBI and Denmark. Stefano, it was very enjoyable to spend time with you outside of work as well, it was the icing on the cake. Research schools and -networks have played an important role in my career. The support from the back office, the research funding, the conferences, and the nice events organized by FEBRI have definitely improved my work. The same applies to the research network Netspar, which I have been part of for many years now. Especially, Marike and Lieke, I have often met you there, and greatly appreciate your endless help and encouragement. Lastly, I would like to thank the collaborations within the Centre for Public Health in Economics and Business (CPHEB) and Aletta's Talent Network (ATN). I experienced the board tasks and meetings to be a welcome broadening of my horizon. A supportive environment is indispensable for bringing out the best in each other, day in and day out. My fellow PhD candidates, fellow research master students, and office mates have made me feel part of a group of friends. Also my friends outside of academia have supported me with more than just research. We have had great times throughout all the years we have known each other. These bonds continue to ...

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Section: Literaturesupporting

confidence: 73%

Health Risks in Old Age

van der Vaart

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“…Such an approach has been shown to better support individuals with complex health and social care needs by considering holistic health and decreasing this negative stigma associated with this population [ 40 ]. The dissemination of information on complex clients to residential care staff is then pivotal to appreciate the diverse backgrounds of older adults [ 39 ] and to redress the inequitable access of marginalized populations into long-term care [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Lost in transition? Community residential facility staff and stakeholder perspectives on previously incarcerated older adults’ transitions into long-term care

et al. 2023

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Background Establishing an effective continuum of care is a pivotal part of providing support for older populations. In contemporary practice; however, a subset of older adults experience delayed entry and/or are denied access to appropriate care. While previously incarcerated older adults often face barriers to accessing health care services to support community reintegration, there has been limited research on their transitions into long-term care. Exploring these transitions, we aim to highlight the challenges of securing long-term care services for previously incarcerated older adults and shed light on the contextual landscape that reinforces the inequitable care of marginalized older populations across the care continuum. Methods We performed a case study of a Community Residential Facility (CRF) for previously incarcerated older adults which leverages best practices in transitional care interventions. Semi-structured interviews were conducted with CRF staff and community stakeholders to determine the challenges and barriers of this population when reintegrating back into the community. A secondary thematic analysis was conducted to specifically examine the challenges of accessing long-term care. A code manual representing the project themes (e.g., access to care, long-term care, inequitable experiences) was tested and revised, following an iterative collaborative qualitative analysis (ICQA) process. Results The findings indicate that previously incarcerated older adults experience delayed access and/or are denied entry into long-term care due to stigma and a culture of risk that overshadow the admissions process. These circumstances combined with few available long-term care options and the prominence of complex populations already in long-term care contribute to the inequitable access barriers of previously incarcerated older adults seeking entry into long-term care. Conclusions We emphasize the many strengths of utilizing transitional care interventions to support previously incarcerated older adults as they transition into long-term care including: 1) education & training, 2) advocacy, and 3) a shared responsibility of care. On the other hand, we underscore that more work is needed to redress the layered bureaucracy of long-term care admissions processes, the lack of long-term care options and the barriers imposed by restrictive long-term care eligibility criteria that sustain the inequitable care of marginalized older populations.

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Unravelling Hidden Inequities in a Universal Public Long-Term Care System

Cited by 2 publications

References 20 publications

Health Risks in Old Age

Health Risks in Old Age

Lost in transition? Community residential facility staff and stakeholder perspectives on previously incarcerated older adults’ transitions into long-term care

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