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居家老年人的医疗保健利用:照顾者负担是否起作用?

Health care utilization among homebound elders: does caregiver burden play a role?

机构信息

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

J Aging Health. 2013 Sep;25(6):1036-49. doi: 10.1177/0898264313497509. Epub 2013 Aug 6.

Abstract

OBJECTIVE

To describe informal caregiver and patient characteristics associated with high caregiver burden in homebound elders and to examine associations between high caregiver burden and patient health care utilization at the practice level.

METHOD

We used a cross-sectional and prospective cohort design to study 214 caregiver-patient dyads in a home-based primary care program.

RESULTS

Informal caregivers with the highest burden were more likely to help with more activities of daily living and instrumental activities of daily living and spend >40 hr/week in caregiving. Patients whose caregivers experienced the highest burden were more likely to be non-White males without 24-hr paid homecare. There were no significant independent associations between high burden and high calls, high visits, or social work involvement.

DISCUSSION

In this medically complex and highly dependent population, further study of how families and other caregivers impact health care utilization is needed.

摘要

目的

描述与居家失能老人中高 caregiver负担相关的非正式照护者和患者特征,并探讨高 caregiver负担与实践层面患者医疗保健利用之间的关联。

方法

我们使用横断面和前瞻性队列设计研究了家庭初级保健计划中的 214 对照顾者-患者对。

结果

负担最重的非正式照护者更有可能帮助完成更多的日常生活活动和工具性日常生活活动,每周照顾时间超过 40 小时。照护者负担最重的患者更可能是非裔或西班牙裔男性,且没有 24 小时付费家庭护理。高负担与高电话、高就诊或社会工作介入之间没有显著的独立关联。

讨论

在这个医疗复杂且高度依赖的人群中,需要进一步研究家庭和其他照护者如何影响医疗保健利用。

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