التفاصيل البيبلوغرافية
| العنوان: |
The impact of the economic status of the disabled elderly dwelling at home on the use of homecare and the quality of that care. |
| المؤلفون: |
SHU-CHING CHANG1, SHIAO-CHI WU2 scwu@ym.edu.tw |
| المصدر: |
Taiwan Journal of Publich Health / Taiwan Gong Gong Wei Sheng Za Zhi. Oct2012, Vol. 31 Issue 5, p446-459. 14p. |
| مصطلحات موضوعية: |
*OLDER people with disabilities, *SOCIAL conditions of people with disabilities, *HOME care services, *ELDER care, *MEDICAL quality control |
| مستخلص: |
Objectives: The aims of this study were to determine the effects of the economic status of the disabled elderly on the risk of too infrequent use of homecare and the quality of longterm care. Methods: The subjects of the study were a retrospective cohort of disabled elderly in Taiwan who received homecare services for the first time and were covered by the National Health Insurance from 2002 to 2006. A generalized estimate equation (GEE) used for the logistic regression was utilized to analyze the factors affecting the risk of fewer homecare visits (<3 times per year). The factors affecting the risks of infection-related hospitalization or pressure sore-related hospitalization were analyzed with a comprehensive Cox regression. Results: A total of 44,856 disabled elderly received homecare for the first time from 2002 to 2006. After the confounding variables were controlled, the comparative risks between different economic status groups were as follows: the risk of fewer homecare visits for the disabled elderly with high economic status was lower than the risk for those with low economic status (Odds ratio [OR]=0.92; 95% confidence interval [CI], 0.86-0.99, p=0.0307). The risk of infection-related hospitalization for the disabled elderly with high economic status was lower than the risk for those with low economic status (Hazard ratio [HR]=0.95, 95% CI:0.92-0.98, p=0.0025). The risk of pressure sore-related hospitalization for the disabled elderly with high economic status was lower than the risk for those with low economic status (HR=0.92, 95% CI:0.85-1.00, p=0.0422). Conclusions: The disabled elderly of low economic status made less use of homecare services and received a lower quality of homecare even though it was provided by National Health Insurance for free. Based on these findings, we suggest that policy makers provide a traffic subsidy to the economically disadvantaged disabled elderly who receive homecare services, improve household sanitation, and promote specialized instruction about homecare during discharge planning and home visits. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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