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Ren W, He R, Tarimo CS, Sun L, Wu J, Zhang L. Willingness and influencing factors of old-age care mode selection among middle-aged and older adults in Henan Province, China. BMC Geriatr 2024; 24:72. [PMID: 38238651 PMCID: PMC10797948 DOI: 10.1186/s12877-023-04559-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/02/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The choice of old-age care methods or places plays an important role in improving the quality of life and well-being of older adults. This study aimed to analyze the choices of various old-age care modes (OCMs) among middle-aged and older adults (MOA) aged 40 years and older in Henan Province, China, and to explore the influence of personal health status, perspectives on old-age (POA) and external support received on their choices. METHODS This study analyzed the data from the previous survey which included 911 MOA. The mean comparison method was used to analyze the evaluation of MOA prior to selecting OCMs, and the effect of individual characteristics, external support received, and personal health status on the choice of OCM for MOA was assessed by Logistic regression (LR) and Concentration Index. The Mediation Effect Model was used to explore effect manner and scope of MOA' POA in their choice of OCM. RESULTS The overall scores for MOA on the choice of the home-based, community-family, retirement village, nursing homes OCM were 4.06 ± 0.81, 3.70 ± 0.88, 3.72 ± 0.90, 3.49 ± 0.97, respectively. The LR model indicated that education level, number of children, relationship between family members and the relationship with neighbors affected the choice of OCM for MOA (P < 0.05). Difference in OCM selection was relatively the largest based on the individual's POA (Concentration index = -0.0895 ~ -0.0606), and it was shown to play a mediating role in other factors influencing the choice of OCM for MOA (Mediation effect = -0.002 ~ 0.013). CONCLUSIONS The evaluation of MOA on choosing a non-home OCM was generally, and the number of children and external support received were shown to have a relatively substantial impact on the choice of OCM among MOA, however, their power was affected by MOA' POA. Policy makers could encourage the MOA' selection of non-home OCM by improving the relationship among MOA persons while positively transforming their POA.
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Affiliation(s)
- Weicun Ren
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
- Wuhan University Health Governance Research Centre, Wuhan University, Wuhan, China
| | - Ruibo He
- School of Political Science and Public Administration, Wuhan University, Wuhan, China.
- School of Finance and Public Administration, Hubei University of Economics, 8 Yangqiaohu Avenue, Jiangxia District, Wuhan City, Hubei Province, China.
| | - Clifford Silver Tarimo
- Department of Science and Laboratory Technology, Dares Salaam Institute of Technology, Dares Salaam, Tanzania
| | - Lei Sun
- Department of Health Management, Sanquan College of Xinxiang Medical University, Xinxiang, China
| | - Jvxiao Wu
- School of Communication and Journalism, Wuhan University, Wuhan, China
| | - Liang Zhang
- School of Political Science and Public Administration, Wuhan University, Wuhan, China.
- Wuhan University Health Governance Research Centre, Wuhan University, Wuhan, China.
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Ma Q, Sun F, Mi H. Long-Term Care Preferences Among Chinese Older Adults: The Role of Sociocultural Factors. J Aging Soc Policy 2023; 35:806-823. [PMID: 37838962 DOI: 10.1080/08959420.2023.2265770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/08/2023] [Indexed: 10/17/2023]
Abstract
Understanding individuals' long-term care preferences is essential to the provision of person-centered care. This study aims to describe the preferences for long-term care settings and investigates sociocultural factors associated with long-term care preferences among older Chinese adults. Responses from 22,112 older adults aged 60 years or above were analyzed using multinomial logistic regression. Four ideal long-term care settings were identified: in-home care, community day care, institutional care, and undecided long-term care arrangements. The study found that the majority of participants desired to age in place at home, regardless of their health status and social support conditions. Therefore, research and advocacy efforts are needed to inform policymakers to strategically develop home-based long-term care supports in China.
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Affiliation(s)
- Qiyini Ma
- School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, MI, USA
| | - Hong Mi
- School of Public Affairs, Zhejiang University, Hangzhou, China
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de Jong L, Schmidt T, Carstens AK, Damm K. The impact of different care dependencies on people's willingness to provide informal care: a discrete choice experiment in Germany. HEALTH ECONOMICS REVIEW 2023; 13:35. [PMID: 37269446 DOI: 10.1186/s13561-023-00448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Informal care provided by family members, friends, or neighbors is a major pillar in the German long-term care system. As the number of care-dependent older adults grow, ensuring their future care still relies on the willingness of family members, friends, or neighbors to assume the role of an informal caregiver. This study aimed to investigate the impact on people's willingness to provide informal care to a close relative with predominately cognitive compared to physical impairments. METHODS An online survey was distributed to the general population in Germany, which resulted in 260 participants. A discrete choice experiment was created to elicit and quantify people's preferences. A conditional logit model was used to investigate preferences and marginal willingness-to-accept values were estimated for one hour of informal caregiving. RESULTS Increased care time per day (hours) and expected duration of caregiving were negatively valued by the participants and reduced willingness to care. Descriptions of the two care dependencies had a significant impact on participants' decisions. Having to provide care to a close relative with cognitive impairments was slightly preferred over caring for a relative with physical impairments. CONCLUSIONS Our study results show the impact of different factors on the willingness to provide informal care to a close relative. How far the preference weights as well as the high willingness-to-accept values for an hour of caregiving can be explained by the sociodemographic structure of our cohort needs to be investigated by further research. Participants slightly preferred caring for a close relative with cognitive impairments, which might be explained by fear or discomfort with providing personal care to a relative with physical impairments or feelings of sympathy and pity towards people with dementia. Future qualitative research designs can help understand these motivations.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
| | - Torben Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
| | - Ann-Katrin Carstens
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
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de Jong L, Schmidt T, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Informelle Pflege und Berufstätigkeit: Einflussfaktoren auf die Bereitschaft. ZEITSCHRIFT FÜR EVIDENZ, FORTBILDUNG UND QUALITÄT IM GESUNDHEITSWESEN 2023:S1865-9217(23)00008-9. [PMID: 37019756 DOI: 10.1016/j.zefq.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 12/30/2022] [Accepted: 01/23/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION The proportion of people in need of care will continue to rise in Germany. In 2019, the majority of people in need of care was cared for at home. Reconciling caregiving and work poses a heavy burden for many caregivers. Therefore, a monetary compensation for care is being discussed politically in order to facilitate the reconciliation of work and care. The aim of this study was to investigate whether and under which circumstances a sample of the German population is willing to care for a close relative. A particular focus was placed on the willingness to reduce working hours, the importance of the expected period of caregiving, and monetary compensation. METHODS A primary data collection was conducted in two modes using a questionnaire. A self-completion postal survey was sent out via the AOK Lower Saxony and complemented with an online survey. Data was analysed descriptively and using logistic regression. RESULTS 543 participants were included. 90% of the sample surveyed was willing to provide care for a close relative, with the majority stating that their willingness depended on various factors: both the health status and the person of the family member needing care had the greatest influence. 34% of the employed respondents were not willing to reduce their working hours, mostly for financial reasons. DISCUSSION AND CONCLUSION Many older adults want to stay in their homes for as long as possible. Thus, the willingness to provide and take over the role of informal caregiver is and will remain a central pillar of the German care system. Negotiating between informal caregiving and professional activities often creates a substantial burden. For people from lower income households monetary compensation might enhance their willingness to provide informal care. However, in order to increase the willingness to engage in informal care of people from different backgrounds and life stages, flexible approaches are needed that go beyond monetary compensation.
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de Jong L, Schmidt T, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Willingness to provide informal care to older adults in Germany: a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:425-436. [PMID: 35689744 PMCID: PMC10060358 DOI: 10.1007/s10198-022-01483-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/12/2022] [Indexed: 06/05/2023]
Abstract
As the German population is continually aging and the majority of older adults still wish to 'age in place', the need for informal care provided by family and friends will correspondingly continue to increase. In addition, while the need for formal (professional) care services is also likely to increase, the supply already does not meet the demand in Germany today. The aim of our study is the elicitation of people's willingness to provide informal care by means of a discrete choice experiment. The self-complete postal survey was disseminated to a random sample of the German general population in Lower Saxony. Data cleansing resulted in a final sample size of 280 participants. A conditional logit and a latent class model were estimated. All attributes were judged as highly relevant by the respondents. The results revealed that an increase in the care hours per day had the greatest negative impact overall on the willingness to provide informal care in our sample. The marginal willingness-to-accept for 1 h of informal care was €14.54 when having to provide informal care for 8 h in reference to 2 h per day. This value is considerably higher than the national minimum wage of €9.82. A three-class latent class model revealed preference heterogeneity. While a monetary compensation is often discussed to increase the willingness and availability of informal care in a country, our results show that this statement could not be generalized within our entire sample.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany.
| | - Torben Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
| | | | - Sveja Eberhard
- Health Services Research Unit, AOK Lower Saxony, Hannover, Germany
| | - Jan Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
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de Jong L, Zeidler J, Damm K. A systematic review to identify the use of stated preference research in the field of older adult care. Eur J Ageing 2022; 19:1005-1056. [PMID: 36692785 PMCID: PMC9729451 DOI: 10.1007/s10433-022-00738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 11/09/2022] Open
Abstract
In the design of long-term care systems, preferences can serve as an essential indication to better tailor services to the needs, wishes and expectations of its consumers. The aim of this systematic review was to summarize and synthesize available evidence on long-term care preferences that have been elicited by quantitative stated-preference methods. The databases PubMed and Web of Science were searched for the period 2000 to 2020 with an extensive set of search terms. Two independent researchers judged the eligibility of studies. The final number of included studies was 66, conducted in 19 different countries. Studies were systematized according to their content focus as well as the survey method used. Irrespective of the heterogeneity of studies with respect to research focus, study population, sample size and study design, some consistent findings emerged. When presented with a set of long-term care options, the majority of study participants preferred to "age in place" and make use of informal or home-based care. With increasing severity of physical and cognitive impairments, preferences shifted toward the exclusive use of formal care. Next to the severity of care needs, the influence on preferences of a range of other independent variables such as income, family status and education were tested; however, none showed consistent effects across all studies. The inclusion of choice-based elicitation techniques provides an impression of how studies operationalized long-term care and measured preferences. Future research should investigate how preferences might change over time and generations as well as people's willingness and realistic capabilities of providing care.
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Affiliation(s)
- Lea de Jong
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Otto-Brenner-Str.7, 30159, Hannover, Germany.
| | - Jan Zeidler
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Otto-Brenner-Str.7, 30159, Hannover, Germany
| | - Kathrin Damm
- Leibniz University Hannover, Center for Health Economics Research Hannover (CHERH), Otto-Brenner-Str.7, 30159, Hannover, Germany
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de Jong L, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences. BMC Geriatr 2021; 21:207. [PMID: 33765937 PMCID: PMC7992803 DOI: 10.1186/s12877-021-02149-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 03/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background At present, the provision of informal care to older relatives is an essential pillar of the long-term care system in Germany. However, the impact of demographic and social changes on informal caregiving remains unclear. Methods Thirty-three semi-structured interviews were conducted with care consultants, informal caregivers and people without any caregiving experience to explore if people are willing to provide older adult care and how prepared these are with regard to the possibility of becoming care dependent themselves. Results In total, three main categories (willingness to provide care, willingness to receive care and information as preparation) with several sub-categories were identified during the content analysis. While almost all interviewees were willing to provide care for close family members, most were hesitant to receive informal care. Other factors such as the available housing space, flexible working hours and the proximity of relatives were essential indicators of a person’s preparedness to provide informal care. It is, however, unclear if care preferences change over time and generations. Six out of 12 informal caregivers and nine out of 14 care consultants also reported an information gap. Because they do not possess adequate information, informal caregivers do not seek help until it is too late and they experience high physical and mental strain. Despite the increased efforts of care consultants in recent years, trying to inform caregivers earlier was seen as almost impossible. Conclusions The very negative perception of caregiving as a burden was a reoccurring theme throughout all interviews and influenced people’s willingness to receive care as well as seeking timely information. Despite recent political efforts to strengthen home-based care in Germany, it remains unclear whether political efforts will be effective in changing individuals’ perceptions of informal caregiving and their willingness to be better prepared for the highly likely scenario of having to care for a close relative or becoming care dependent at a later stage in life. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02149-2.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany.
| | | | - Sveja Eberhard
- Health Services Research Unit, AOK Niedersachsen, Hannover, Germany
| | - Jan Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
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de Jong L, Plöthner M, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Informal and formal care preferences and expected willingness of providing elderly care in Germany: protocol for a mixed-methods study. BMJ Open 2019; 9:e023253. [PMID: 30647033 PMCID: PMC6340479 DOI: 10.1136/bmjopen-2018-023253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In Germany, the number of elderly people in need of care is expected to increase from 2.4 million in 2015 to 3.2 million in 2030. The subsequent rise in demand for long-term care facilities is unlikely to be met by the current care structures and available staff. Additionally, many Germans still prefer to be cared for at home for as long as possible. In light of recent changes, such as increasing employment rates of women and growing geographical distances of family members, informal caregiving becomes more challenging in the future. The aim of this study is to explore preferences for informal and formal care services in the German general population, as well as the expected willingness of providing elderly care. METHODS AND ANALYSIS A mixed-methods approach will be used to explore care preferences and expected willingness of providing elderly care in the German general population. A systematic literature review will be performed to provide an overview of the current academic literature on the topic. Qualitative interviews will be conducted with informal caregivers, care consultants and people with no prior caregiving experiences. A labelled discrete choice experiment will be designed and conducted to quantitatively measure the preferences for informal and formal care in the German general population. People between 18 and 65 years of age will be recruited in cooperation with a (regional) statutory health insurance (AOK Lower Saxony). A mixed multinomial logit regression model and a latent class finite mixture model will be used to analyse the data and test for subgroup differences in care preferences. ETHICS AND DISSEMINATION The study has been approved by the Committee for Clinical Ethics of the Medical School in Hannover. Data will be treated confidential to ensure the participants' anonymity. The results will be discussed and disseminated to relevant stakeholders in the field. TRIAL REGISTRATION NUMBER DRKS00012266.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Hannover, Germany
| | - Marika Plöthner
- Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Hannover, Germany
| | | | - Sveja Eberhard
- Health Services Research Unit, AOK Niedersachsen, Hannover, Germany
| | - Jan Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University of Hannover, Hannover, Germany
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Do Individuals in Old Age Prepare for the Risk of Long-Term Care? Results of A Population-Based Survey in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102189. [PMID: 30297598 PMCID: PMC6210161 DOI: 10.3390/ijerph15102189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to identify specific actions and financial precautions undertaken by individuals in preparation for their long-term care needs, as well as to determine the correlates of these actions. A population-based survey of the German population aged 65 years and above (n = 1006) was used. Individuals were asked whether they have undertaken financial preparations for their long-term care needs (no; yes). With respect to specific actions, individuals were asked whether they (no; yes): (i) Had obtained information (e.g., from doctor, internet, care support center, care facility), (ii) had modified their home (e.g., installed a stair lift), and (iii) had moved (e.g., old-age housing, care in relatives’ homes). In total, 30.4% had undertaken financial preparations for their long-term care needs. With respect to the specific actions undertaken, 6.5% had obtained information, 4.8% modified their home, and 7.3% had moved. The outcome measure, ‘had modified home’, was positively associated with lower age, West Germany, and lower self-rated health. The outcome measure, ‘had moved’, was positively associated with being female, and higher education. The outcome measure, ‘financial preparations for long-term care needs‘, was positively associated with lower age, West Germany, higher education, being born in Germany, and private health insurance. It is alarming that only around one in three individuals aged 65 and older had undertaken financial preparations for long-term care needs, and that far fewer individuals had undertaken other actions to prepare for their long-term care needs. The provision of timely information regarding the risk of long-term care, as well as its associated costs, may assist in sustaining the satisfaction of long-term care recipients. It may also help to reduce the risk of long-term care for individuals in old age.
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Abstract
ABSTRACTPerson-centred provision of long-term care (LTC) requires information on how individuals value respective LTC services. The literature on LTC preferences has not been comprehensively reviewed, existing summaries are contradictory. An explorative, scoping review was conducted to provide a thorough methodological description and results synthesis of studies that empirically investigated LTC preference outcomes based on respondents’ statements. A wide search strategy, with 18 key terms relating to ‘LTC’ and 31 to ‘preferences’, was developed. Database searches in PubMed, Ovid and ScienceDirect were conducted in February 2016. The 59 studies meeting the inclusion criteria were grouped and methodically described based on preference elicitation techniques and methods. Despite substantial methodological heterogeneity between studies, certain findings consistently emerged for the investigated LTC preference outcomes. The large majority of respondents preferred to receive LTC in their known physical and social environment when care needs were moderate, but residential care when care needs were extensive. Preferences were found to depend on a variety of personal, environmental, social and cultural aspects. Dependent individuals aspired to preserve their personal and social identity, self-image, independence, autonomy, control and dignity, which suggests that LTC preferences are a function of the perceived ability of a specific LTC arrangement to satisfy peoples’ basic physiological and mental/social needs. Research on LTC preferences would greatly profit from a standardisation of respective concepts and methods.
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Hajek A, Lehnert T, Wegener A, Riedel-Heller SG, König HH. Factors associated with preferences for long-term care settings in old age: evidence from a population-based survey in Germany. BMC Health Serv Res 2017; 17:156. [PMID: 28222774 PMCID: PMC5320639 DOI: 10.1186/s12913-017-2101-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/17/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Long-term care is one of the most pressing health policy issues in Germany. It is expected that the need for long-term care will increase markedly in the next decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany. METHODS Based on expert interviews and a systematic review, a questionnaire was developed to quantify long-term care preferences. Data were drawn from a population-based survey of the German population aged 65 and over in 2015 (n = 1006). RESULTS In multiple logistic regressions, preferences for home care were positively associated with providing care for family/friends [OR: 1.6 (1.0-2.5)], lower self-rated health [OR: 1.3 (1.0-1.6)], and no current need of care [OR: 5.5 (1.2-25.7)]. Preferences for care in relatives' homes were positively associated with being male [OR: 2.0 (1.4-2.7)], living with partner or spouse [OR: 1.8 (1.3-2.4)], having children [OR: 1.6 (1.0-2.5)], private health insurance [OR: 1.6 (1.1-2.3)], providing care for family/friends [OR: 1.5 (1.1-2.0)], and higher self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in assisted living were positively associated with need of care [OR: 1.9 (1.0-3.5)] and higher education [for example, University, OR: 3.5 (1.9-6.5)]. Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0-3.1)] and lower self-rated health [OR: 1.2 (1.0-1.4)]. Preferences for care in a foreign country were positively associated with lower age [OR: 1.1 (1.0-1.2)] and being born abroad [OR: 5.5 (2.7-11.2)]. CONCLUSIONS Numerous variables used are sporadically significant, underlining the complex nature of long-term care preferences. A better understanding of factors associated with preferences for care settings might contribute to improving long-term care health services.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Thomas Lehnert
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annemarie Wegener
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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[Demographic change, people needing long-term care, and the future need for carers. An overview]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 56:1040-7. [PMID: 23884518 DOI: 10.1007/s00103-013-1742-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Both the number of people in need of long-term care and the number of carers will grow strongly in the future. This development is influenced by several factors. Firstly, demographic change will increase the number of people in need of long-term care. This article analyzes how demographic change is shifting the balance of age groups that need long-term care using the"greying index" and parent-support ratio. Secondly, changes in the health status of the elderly modify the need for long-term care. A decrease in morbidity could reduce the future need for long-term care. Thirdly, two thirds of all people in need of long-term care are cared for at home today, for the most part by their relatives exclusively. The demographic potential for family care will not increase in future. Thus, it can be assumed that a greater part of long-term care will be relocated to institutions and that this will increase the demand for professional carers. A synopsis of diverse projections reveals that in future, the number of carers required for long-term care will be much higher than that of today.
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Kuhlmann E, Larsen C. Langzeitpflege im europäischen Vergleich. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:1064-71. [DOI: 10.1007/s00103-013-1745-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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