KU Leuven and Steunpunt WVG, Leuven, Belgium.
Eur J Public Health. 2013 Apr;23(2):241-6. doi: 10.1093/eurpub/cks068. Epub 2012 Jun 8.
When explaining the use of care, the context of the care gains importance. This article focuses on the influence of the municipality on the lives of the elderly regarding the usage of different forms of care, whereas controlling for the effect of individual characteristics.
Two databases on the individual characteristics of elderly Flemish people living at home were combined with a database on municipal characteristics. The effect of municipal characteristics was measured through multi-level logistic regression.
A higher mean income per inhabitant and a lower number of inhabitants/100 km(2) have a positive effect on the use of informal home care. The use of home care services is positively influenced by a higher family care index and an increasing relative number of hours of domestic care provided in the municipality. Receiving care from a general practitioner, medical specialist, dentist, emergency department, community nurse, physiotherapist, home aid, day-care centre or hospital with overnight stay is not influenced by the municipality's characteristics. The use of public welfare services, meals-on-wheels programs or hospital outpatients' services, however, are affected by the municipality, but cannot be fully explained by the model.
The municipality that an elderly person lives in has an impact on the amount and the types of care an elderly person receives. Persons with similar care needs and similar individual characteristics can receive very different care when they live in different municipalities. This is quite a challenging finding for researchers, as well as for care providers and policy makers.
在解释护理的使用时，护理的背景变得尤为重要。本文主要关注的是在控制个人特征的影响下，市政当局对老年人使用不同形式护理的生活的影响。
将居住在家庭中的老年弗拉芒人个体特征的两个数据库与市政特征数据库相结合。通过多层次逻辑回归来衡量市政特征的影响。
居民人均收入较高和每平方公里居民人数较少对非正式家庭护理的使用有积极影响。家庭护理指数较高，市政当局提供的家庭护理时间相对增加，对家庭护理服务的使用有积极影响。接受全科医生、专科医生、牙医、急诊部、社区护士、物理治疗师、家庭助理、日托中心或住院过夜护理，不受市政当局特征的影响。然而，公共福利服务、送餐服务或医院门诊服务的使用受到市政当局的影响，但无法完全用模型解释。
老年人居住的市政当局会影响老年人接受的护理的数量和类型。当具有相似护理需求和相似个体特征的人居住在不同的市政当局时，他们可能会接受非常不同的护理。这对研究人员以及护理提供者和政策制定者来说都是一个颇具挑战性的发现。
