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Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe.


ABSTRACT:

Objectives

We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care ("de-familization").

Method

We use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC.

Results

We find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization.

Discussion

The results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.

SUBMITTER: Floridi G 

PROVIDER: S-EPMC7756692 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe.

Floridi Ginevra G   Carrino Ludovico L   Glaser Karen K  

The journals of gerontology. Series B, Psychological sciences and social sciences 20210101 1


<h4>Objectives</h4>We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care ("de-familization").<h4>Method</h4>We use survey data from SHARE on disabled older adul  ...[more]

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