Hammar Teija, Rissanen Pekka, Perälä Marja-Leena
STAKES, National Research and Development Centre for Welfare and Health, Lintulahdenkuja 4, P.O.Box 220, 00531 Helsinki, Finland.
Tampere School of Public Health, University of Tampere, Tampere, Finland.
Eur J Ageing. 2008 May 21;5(2):147. doi: 10.1007/s10433-008-0078-4. eCollection 2008 Jun.
The aims of the study were to describe (1) the need for help as well as the use and costs of services of home help and/or home nursing (home care) and (2) to identify the variables associated with the use and costs of health and social care services. A total of 721 Finnish home-care clients were interviewed in 2001. The need for help was assessed by basic and instrumental activities of daily Living (ADL) and in terms of pain and illness, rest and sleep, psychosocial well-being and social and environment variables. The Anderson-Newman model was used to study predictors of use of services, including visits of home-care personnel and visits to the doctor, nurse, physiotherapist, laboratory and hospital. Weekly costs of services were calculated. Data were analyzed using multivariate analyses. The clients had poor functional ability and they needed help at least once a week with, on average, 6 out of 15 ADL functions, and 5 out of 13 items relating to pain and illnesses, rest and sleep, psychosocial well-being and social and environment items. The enabling and need variables, particularly the variables "living alone" and "perceived need for help", were important predictors for the use of services. Social care constituted more than half of the average weekly costs of municipalities. The perceived need for help with basic ADL was associated with higher costs. To ensure the quality of life among home-care clients while keeping costs reasonable is a challenge for municipalities.
（1）对帮助的需求以及居家护理和/或家庭护理（居家照料）服务的使用情况和成本；（2）确定与健康和社会护理服务的使用及成本相关的变量。2001年，共对721名芬兰居家照料客户进行了访谈。通过日常生活基本活动和工具性活动（ADL）以及疼痛与疾病、休息与睡眠、心理社会福祉以及社会和环境变量来评估对帮助的需求。采用安德森 - 纽曼模型研究服务使用的预测因素，包括居家护理人员的探访以及去看医生、护士、物理治疗师、实验室和医院的次数。计算了服务的每周成本。使用多变量分析对数据进行分析。客户的功能能力较差，他们平均每周至少需要一次帮助，在15项ADL功能中有6项需要帮助，在与疼痛和疾病、休息与睡眠、心理社会福祉以及社会和环境项目相关的13项中有5项需要帮助。促成因素和需求变量，特别是“独居”和“感知到的帮助需求”变量，是服务使用的重要预测因素。社会护理占市政当局平均每周成本的一半以上。对基本ADL帮助的感知需求与更高的成本相关。在保持成本合理的同时确保居家照料客户的生活质量，对市政当局来说是一项挑战。
