Albertini Marco, Pavolini Emmanuele
Department of Political and Social Sciences, University of Bologna, Italy.
Department of Political Sciences, Communication and International Relations, University of Macerata, Italy.
J Gerontol B Psychol Sci Soc Sci. 2017 May 1;72(3):510-521. doi: 10.1093/geronb/gbv038.
The general aim of the article is to incorporate the stratification perspective into the study of (long-term) care systems. In particular, 3 issues are investigated: the extents to which (a) personal and family resources influence the likelihood of using formal care in later life; (b) the unequal access to formal care is mediated by differences in the availability of informal support; (c) the relationship between individuals' resources and the use of formal care in old age varies across care regimes and is related to the institutional design of long-term care policies.
Data from Waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe for 4 countries: Denmark, Germany, France, and Italy, and population aged at least 65 (N = 9,824) were used. Population-averaged logit models were used.
Logit models revealed that in terms of access to formal care: an individual's educational level plays a limited role; family networks function similarly across the countries studied; in general, financial wealth does not have a significant effect; there is a positive relation between income and the use of formal care in Germany and Italy, and no significant relation in France and Denmark; home ownership has a negative effect in Germany and Denmark. On accounting for informal care, inequality associated with individuals' economic resources remains substantially unaltered.
The study shows that care systems based on services provision grant higher access to formal care and create lower inequalities. Moreover, countries where cash-for-care programs and family responsibilities are more important register inequalities in the use of formal care. Access to informal care does not mediate the distribution of formal care.
本文的总体目标是将分层视角纳入（长期）护理体系的研究。具体而言，研究了三个问题：（a）个人和家庭资源在多大程度上影响晚年使用正规护理的可能性；（b）非正式支持可获得性的差异如何调节正规护理的不平等获取；（c）个体资源与老年正规护理使用之间的关系在不同护理制度下有所不同，且与长期护理政策的制度设计相关。
使用了来自欧洲健康、老龄化和退休调查第1波和第2波的数据，涉及丹麦、德国、法国和意大利4个国家，以及年龄至少为65岁的人口（N = 9824）。采用了总体平均logit模型。
logit模型显示，在获得正规护理方面：个人教育水平作用有限；在所研究的国家中，家庭网络的作用相似；总体而言，金融财富没有显著影响；在德国和意大利，收入与正规护理的使用呈正相关，在法国和丹麦则无显著关系；在德国和丹麦，房屋所有权有负面影响。在考虑非正式护理后，与个人经济资源相关的不平等基本保持不变。
该研究表明，基于服务提供的护理体系能提供更高的正规护理获取机会，并减少不平等。此外，在护理现金计划和家庭责任更为重要的国家，正规护理使用方面存在不平等。获得非正式护理并不能调节正规护理的分配。
