The Effect of Older People's Economic Resources on Care Home Entry Under the United Kingdom's Long-Term Care Financing System (original) (raw)
Related papers
SpringerPlus, 2014
In low or middle income countries chronic diseases are rapidly becoming the main cause of disease burden. However, the main focus of health policymakers has been on preventing death from cancer and heart disease, with very little attention to the growing problem of long-term needs for care (dependence). Numbers of dependent older people are set to quadruple by 2050. The economic impact of providing long-term care is likely to be substantial. Methods/design: The study uses mixed methods and draws on and extends the population-based surveys conducted by the 10/66 Dementia Research Group. We focus on two countries in Latin America (Peru and Mexico), China and Nigeria. The surveys comprised baseline surveys of health, socioeconomic circumstances and care arrangements, repeated three to four years later. We are going back to these households to make a detailed assessment of the overall economic status and the use of health services by all family members. We will compare households where: a) an older resident became dependent between baseline and follow-up (incident care), b) one or more older people were dependent at both time points (chronic care), b) c) no older residents had needs for care (control households) for household income, consumption, healthcare expenditure and economic strain. In each of the four countries we are carrying out six detailed household 'case studies' to explore in more depth the economic impacts of dependence, and the social relations between household members and others in their network.
Age and Ageing, 2007
Background: Only a minority of older people in England and Wales live in institutional care, but among the older of the old, this minority is large. Disability is the major driver of admissions, but socio-demographic factors are also relevant. Understanding more about the influence of these is important for planning by long-term care. Objective: To investigate effects of socio-demographic factors, including housing tenure, household type, marital status, and number of children, on the proportions of elderly people who made a transition from living in the community in 1991 to living in institutional care in 2001. Subjects and setting: Nationally representative record linkage study including 36,650 people aged 65 years and over, living in the community in England and Wales in 1991, who were still alive in 2001. Nineteen thousand women aged 75-89 years in 2001 were included in additional analyses of effects of parity (number of children borne). Methods: Bi-variate and multivariate analyses of variations in sample proportions, who by 2001 were resident in institutional care. Results: 4.3% of men and 9.3% of women in the surviving sample then aged 75 years and over, were in institutional care in 2001. Older age, living in rented accommodation, living alone in 1991 and being unmarried in 2001, as well as long-term illness, were associated with higher proportions making this transition. Women had higher risks than men. Childless women aged 64-79 years in 1991 had a 25% higher risk than women with children of being in institutional care in 2001. Conclusion: Socio-demographic factors continue to influence risks of entry to institutional care in England and Wales.
The report of the study is in two parts. This volume reports on the longitudinal study that was started in autumn 1995, and continued until 1999, some time after implementation of the reforms introduced in 1993 by the NHS and Community Care Act 1990, which had extended local authorities' responsibilities for assessing and funding residents. This part of the study focused on the characteristics of newly admitted long-stay publicly-funded residents, and their outcomes and costs over the following 3½ years. The survey covered approximately 2500 residents in 18 local authorities. Information was collected on: l their personal characteristics, health, dependency and charges at the time of admission l their circumstances prior to admission l their subsequent moves and survival, health and dependency at 6, 18, 30 and 42 months after admission. Together with its companion report, which describes the cross-sectional survey of homes and residents (Netten et al., 2001a, Care Homes for Older People: Volume 1. Facilities, Residents and Costs), this is a valuable source of information for the future and will provide much information for the policy debate. The data on which this report is based will be made publicly available in due course.
European Journal of Ageing, 2017
Long-term care (LTC) use increases with ageing due to an age-related increase in disability. Both the levels of disability and social resources vary among socioeconomic groups. The association of socioeconomic status with LTC use is largely unexplored for the oldest old. This study examined how occupational class is associated with LTC use among nonagenarians in the context of universal care coverage. A population-based prospective cohort study with 2,862 participants who answered the Vitality 90+ Study surveys in 2001, 2003, 2007, or 2010 in Tampere, Finland, was combined with national register data on LTC use. LTC use in total and separately for publicly and privately provided LTC facilities was assessed in a cross-sectional setting and during the 34-month follow-up by using logistic regression and competing-risks regression methods. Functional status, multimorbidity, family relations, and help at home were controlled. In total or public LTC use, only a few differences between occupational classes were found at baseline. However, upper non-manuals used more private LTC than lower non-manuals (OR 0.54, 95% CI 0.35-0.85), skilled manuals (OR 0.40, 95% CI 0.26-0.62) or housewives (OR 0.40, 95% CI 0.22-0.74). There were no statistically significant differences in entering any kind of LTC after adjustments for all independent variables. During the study period, the share of privately provided care out of all LTC increased and the upper non-manuals no more used private care more than other groups. This study underlines the importance of following the structural changes in LTC provision to guarantee that the need for LTC is met equally for all socioeconomic groups.
Research Square (Research Square), 2022
Background Long-term care (LTC), poverty, and socioeconomic deprivation are globally signi cant social issues. Ongoing population aging trends and the recent social and health emergencies caused by the COVID-19 pandemic crisis have highlighted the need for macro-level LTC and welfare system sustainability strategies. At the micro level, the relationship between LTC needs and the risk of socioeconomic deprivation and poverty should be taken into account to promote more targeted and innovative policies worldwide. This scoping review explores the relationship between LTC needs, the health status of older people, and the risk of socioeconomic deprivation for their families in order to understand how the literature interprets these concepts and the relationship between them and to identify any potential gaps in this regard. Methods The methodology considers different relevant sources: a) the guidelines for ScR proposed by Lockwood et al. [1]; b) the Munn et al. [2] recommendations; c) the PRISMA guideline for Scoping Reviews [3]; and d) the Joanna Briggs Institute (JBI) checklist [4]; Sixty-three papers are included in the frequency analysis of 9 identi ed categories to respond of aims. Results The ndings reveal the existence of a debate that seeks to understand the different characteristics of the relationship between the investigated issues. Speci c targets (such as older people, caregivers, and households) are used to identify LTC needs, while material deprivation or poverty is used to determine the conditions of deprivation. Relevant gaps in the literature are identi ed in terms of the concepts and approaches of the studies analyzed. The results indicate that the reciprocal relationship between LTC needs, supply, and the risk of socioeconomic deprivation is understudied. Conclusions The simpli cation strategy used in many studies to reduce the relationship's complexity precludes an indepth analysis and debate on some relevant aspects, including the crucial two-way relationship between LTC needs/supply and the risk of socioeconomic deprivation. Future studies should focus on the causal relationship between the two phenomena and identify any internal factors that may be involved. This study was conducted within the framework of the Family International Monitor (FIM) and the SEreDIPE project (Horizon 2020 MSCA-IF-2019 Grant Agreement No. 888102). Using a multidimensional perspective of the concepts "family" and "deprivation" [32], both projects are concerned with familial material and social deprivation, with a particular focus on care needs. 2 Methods To ensure the highest possible standards of reporting, this ScR is based on a methodology that considers the recommendations formulated by the following relevant sources: a) the guidelines for ScR proposed by Lockwood et al. [1]; b) the Munn et al. [2] recommendations; c) the PRISMA guideline for Scoping Reviews [3]; and d) the Joanna Briggs Institute (JBI) checklist [4]. The chosen guidelines are coherent and non-overlapping, as possible risks in this regard (e.g., Lockwood including suggestions from PRISMA guidelines and the JBI checklist) have been adequately considered. The full details of this study protocol are described in Martarelli et al. [33]. By combining these methods, it is ensured that the review's path remains linear and focused, in accordance with Lockwood and Munn's recommendations, while the PRISMA and JBI approaches concurrently limit the loss of potentially useful papers on the topic. Moreover, speci c guidelines support different aspects, such as the suitability of chosen methods (JBI checklist) and the analysis of data (PRISMA). Lastly, the incorporation of these suggestions enabled the authors to consider the pre-planning phase as the starting point for the design of the ScR study protocol. This allowed the authors to focus on a complex and multidimensional issue, such as the relationship between LTC needs and care strategies and the risk of SED. Figure 1 depicts the ScR's owchart. 2.1 Pre-planning Lockwood and colleagues [1] point out that pre-planning is the phase that determines a review project's success. The brainstorming and brief preliminary research conducted during this phase enabled the authors to clarify the conceptual framework, determine speci c research questions, and identify the set of keywords necessary to implement the search.
Health & Social Care in The Community, 2023
Older people prefer to remain living in their own home for as long as possible; however, many require support to do so through health and other care services provided in the home. Tis study aimed to explore the trends in usage of a home-based care service by older people in metropolitan Melbourne and factors associated with unplanned hospitalisations. Tis longitudinal study analysed episodes of home-based care for people aged ≥65 years between 2006 and 2015. An episode of care was defned as the period of time during which the home care services were provided to the client. Care episodes culminated in a planned discharge from the service or an unplanned hospitalisation. Descriptive statistics and multivariable logistic regression were utilised to investigate the characteristics associated with unplanned hospitalisations. Utilisation of home-based care services over the 10-year period showed an increasing rate of use by people aged ≥85 years and a reduced usage rate by females aged 70-84 years and males 75-79 years old. Of 170,001 episodes of care, 43,608 (25.7%) resulted in an unplanned hospitalisation. Home-based care delivered to people aged ≥85 years showed an increasing rate of episodes ending in an unplanned transfer to the hospital. Between 2006 and 2015, individuals aged 85-89 years displayed a rate increase of 18.7% in episodes ending in an unplanned hospitalisation; for those aged ≥90 years, the rate rise was 43.6%. Factors associated with an unplanned hospitalisation included advancing age, male gender, living alone, cognitive dysfunction, and the complexity of medical issues. Health policy has focussed on providing services to enable older people to remain in their own home. Te increasing rate of unplanned hospitalisations for community-dwellers aged ≥85 years suggests more support is required to enable ageing in place.
Demand of elderly people for residential care: an exploratory study
BMC health services research, 2006
Because of the rapid aging population, the demand for residential care exceeds availability. This paper presents the results of a study that focuses on the demand of elderly people for residential care and determinants (elderly people's personal characteristics, needs and resources) that are associated with this demand. Furthermore, the accuracy of the waiting list as a reflection of this demand has been examined. 67 elderly people waiting for admission into a home for the elderly, are subjected to semi-structured interviews. The data are analyzed by using multivariate statistics. Elderly people who indicate that they would refuse an offer of admission into a home for the elderly feel healthier (p = 0.02), have greater self-care agency (p = 0.02) and perceive less necessity of admission (p < 0.01), compared to those who would accept such an offer. Especially the inability to manage everyday activities and the lack of a social network are highly associated with the elderly peo...