Allen Susan, Resnik Linda, Roy Jason
Center for Gerontology and Health Care Research, Brown University, 2 Stimson Avenue, Providence, RI 02912, USA.
Gerontologist. 2006 Feb;46(1):115-23. doi: 10.1093/geront/46.1.115.
The objective of this research is to investigate whether home accommodations influence the amount of human help provided to a nationally representative sample of adults who use wheelchairs.
We analyzed data from the Adult Disability Follow-back Survey (DFS), Phase II, of the Disability Supplement to the 1994-1995 National Health Interview Surveys (NHIS-D). The analytic sample consisted of 899 adults aged 18 and older who reported using wheelchairs in the previous 2 weeks. We conducted logistic regression and ordinary least squares (OLS) regression analyses to test the influence of home accommodations on the receipt of any human help, and among respondents who received help, on the hours of help received, respectively. We analyzed paid and unpaid help separately.
Home accommodations were related to the receipt of unpaid, but not paid, help. Relative to having no home accommodations, the presence of each additional accommodation decreased the odds of having unpaid help by 14% (OR =.86; 95% CI =.76,.97). Additionally, we observed an inverse relationship between the number of accommodations in the home and hours of unpaid help (p <.01). For wheelchair users who live alone, specific types of home accommodations were also inversely related to hours of unpaid help.
Policies that reimburse for home accommodations may be an efficient response to the growing demand for home-care support while enabling greater autonomy and independence for people who use wheelchairs.
本研究的目的是调查家庭设施是否会影响向全国具有代表性的成年轮椅使用者样本提供的人力帮助的数量。
我们分析了1994 - 1995年国家健康访谈调查残疾补充部分（NHIS - D）第二阶段成人残疾随访调查（DFS）的数据。分析样本包括899名18岁及以上的成年人，他们报告在过去两周内使用轮椅。我们进行了逻辑回归和普通最小二乘法（OLS）回归分析，以分别测试家庭设施对是否获得任何人力帮助的影响，以及在获得帮助的受访者中对获得帮助的时长的影响。我们分别分析了有偿和无偿帮助。
家庭设施与获得无偿帮助有关，但与获得有偿帮助无关。相对于没有家庭设施，每增加一项设施，获得无偿帮助的几率降低14%（比值比=0.86；95%置信区间=0.76，0.97）。此外，我们观察到家庭设施的数量与无偿帮助的时长之间存在负相关关系（p<0.01）。对于独居的轮椅使用者，特定类型的家庭设施也与无偿帮助的时长呈负相关。
为家庭设施提供报销的政策可能是对家庭护理支持需求不断增长的有效应对措施，同时能让轮椅使用者获得更大的自主权和独立性。
