Home and Community Care Digest

Home and Community Care Digest March 2003 : 0-0

Small social networks, depression, and modifiable health conditions such as poor foot health affect home care services utilization in the UK

Abstract

This study investigates social networks, emotional problems and modifiable health conditions as potential determinants of the use of public and private home care services by UK seniors living in the community. Changes in patients' emotional problems, poor foot health, incontinence, or incidence of falls impact home care services utilization rates. Policy makers looking to contain seniors' demand for home care services should target service expansion to: depression, fall prevention, foot health, urinary incontinence, preventative home visits, and hearing problems.
Background: Previous research has investigated age, gender, and health needs as factors determining use of home care services. This study investigates the roles of social networks, emotional problems and modifiable health conditions in determining the use of public and private home care services by UK seniors living in the community.

Method: A postal questionnaire, stratified by age and sex, was sent to a random sample of 2000 seniors registered with 11 general practices in Bristol. The sample included those living in a range of community settings, including nursing homes and private residences. Questions were posed regarding: the use of both public and private home care services over the previous 3 months, demographic factors, health factors, and measures of social support. Data were analyzed separately for men and women.

Findings: The response rate for the questionnaire was high (79%). 26% had used either public or private home care services over the previous three months: 28% of women had used services versus 22% of men. The following factors were associated with home care use (public and private) by both sexes: advanced age, not owning a car, living alone, having a small social network, and deteriorating overall health (particularly among those with cognitive and/or emotional problems, or increased pain). Modifiable conditions such as poor foot health and negative events such as increased incidence of falls were found to be determinants of home care utilization for both women and men. Among private home care users, poor eyesight in men, and hearing problems and incontinence in women were associated with service use.

Conclusions: Changes in patients' emotional health, foot health, incontinence, or number of falls may influence level of service use. Policy makers looking to contain seniors' demand for home care services should consider targeting service expansion to: depression, fall prevention, foot health, urinary incontinence, preventative home visits, and hearing problems.

Reference: Stoddart, H., Whitley, E., Harvey, I. Sharp, D. What Determines the Use of Home Care Services by Elderly People? Health and Social Care in the Community 2002; 10(5): 348-360.

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