Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Institute of Gerontology, School of Health Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Jönköping, Sweden.
J Alzheimers Dis. 2023;96(2):789-800. doi: 10.3233/JAD-230388.
Long-term care improves independence and quality of life of persons with dementia (PWD). The influence of socioeconomic status on access to long-term care was understudied.
To explore the socioeconomic disparity in long-term care for PWD.
This registry-based study included 14,786 PWD, registered in the Swedish registry for cognitive and dementia disorders (2014-2016). Education and income, two traditional socioeconomic indicators, were the main exposure. Outcomes were any kind of long-term care, specific types of long-term care (home care, institutional care), and the monthly average hours of home care. The association between outcomes and socioeconomic status was examined with zero-inflated negative binomial regression and binary logistic regression.
PWD with compulsory education had lower likelihood of receiving any kind of long-term care (OR 0.80, 95% CI 0.68-0.93), or home care (OR 0.83, 95% CI 0.70-0.97), compared to individuals with university degrees. Their monthly average hours of home care were 0.70 times (95% CI 0.59-0.82) lower than those of persons with university degrees. There was no significant association between education and the receipt of institutional care. Stratifying on persons with Alzheimer's disease showed significant association between lower education and any kind of long-term care, and between income and the hours of home care.
Socioeconomic inequalities in long-term care existed in this study population. Lower-educated PWD were less likely to acquire general long-term care, home care and had lower hours of home care, compared to their higher-educated counterparts. Income was not significantly associated with the receipt of long-term care.
长期护理可以提高痴呆症患者（PWD）的独立性和生活质量。但社会经济地位对获得长期护理的影响尚未得到充分研究。
探索痴呆症患者长期护理的社会经济差异。
本基于登记的研究纳入了 14786 名登记在瑞典认知和痴呆障碍登记处（2014-2016 年）的痴呆症患者。教育和收入是两个传统的社会经济指标，作为主要暴露因素。结果是任何类型的长期护理、特定类型的长期护理（家庭护理、机构护理）以及家庭护理的月平均时长。使用零膨胀负二项回归和二项逻辑回归来检验结果与社会经济地位之间的关系。
与具有大学学历的个体相比，具有义务教育程度的 PWD 接受任何类型的长期护理（OR 0.80，95%CI 0.68-0.93）或家庭护理（OR 0.83，95%CI 0.70-0.97）的可能性较低。他们接受家庭护理的月平均时长比具有大学学历的个体低 0.70 倍（95%CI 0.59-0.82）。教育程度与接受机构护理之间没有显著关联。在阿尔茨海默病患者中进行分层分析显示，较低的教育程度与任何类型的长期护理以及收入与家庭护理时长之间存在显著关联。
在本研究人群中存在长期护理的社会经济不平等。与受过高等教育的个体相比，受教育程度较低的 PWD 获得一般长期护理、家庭护理的可能性较低，且家庭护理时长较短。收入与长期护理的获得没有显著关联。
