Zhang Jinbao, Prunty Jonathan E, Charles Alison C, Forder Julien
Personal Social Services Research Unit, University of Kent, Canterbury, United Kingdom.
Leverhulme Centre for the Future of Intelligence, University of Cambridge, Cambridge, United Kingdom.
J Med Internet Res. 2025 Jan 2;27:e53205. doi: 10.2196/53205.
Requests for public social care support can be made through an online portal. These digital "front doors" can help people navigate complex social care systems and access services. These systems can be set up in different ways, but there is little evidence about the impact of alternative arrangements. Digital front-door systems should help people better access services, particularly low-intensity services (high-intensity care is likely to require a full in-person assessment).
This study aimed to investigate the association between 2 primary digital front door arrangements, easy-read information, and self-assessment tools provided on official websites, and the type of social care support that is offered: ongoing low-level support (OLLS), short-term care (STC) and long-term care (LTC).
Information on front door arrangements was collected from the official websites of 152 English local authorities in 2021. We conducted a cross-sectional analysis using aggregated service use data from official government returns at the local authority level. The independent variables were derived from the policy information collected, specifically focusing on the availability of online digital easy-read information and self-assessment tools for adults and caregivers through official websites. The dependent variables were the rates of using social care support, including OLLS, STC, and LTC, across different age groups: the adult population (aged 18 and older), younger population (aged between 18 and 64 years), and older population (aged 65 and older). Multivariate regression analysis was used to examine the association between digital front door arrangements and access to social care support, controlling for population size, dependency level, and financial need factors.
Less than 20% (27/147) of local authorities provided an integrated digital easy-read format as part of their digital front door system with about 25% (37/147) adopting digital self-assessment within their system. We found that local authorities that offered an integrated digital easy-read information format showed higher rates of using OLLS (β coefficient=0.54; P=.03; but no statistically significant association with LTC and STC). The provision of an online self-assessment system was not associated with service use in the 1-year (2021) cross-sectional estimate, but when 2 years (2020 and 2021) of service-use data were analyzed, a significant positive association was found on OLLS rates (β coefficient=0.41; P=.21). Notably, these findings were consistent across different age groups.
These findings are consistent with our hypothesis that digital systems with built-in easy-read and self-assessment may make access to (low-intensity) services easier for people. Adoption of these arrangements could potentially help increase the uptake of support among those who are eligible, with expected benefits for their care-related well-being. Given the limited adoption of the digital front door by local authorities in England, expanding their use could improve care-related outcomes and save social care costs.
公众可通过在线门户申请社会护理支持。这些数字化“前门”有助于人们在复杂的社会护理系统中找到方向并获取服务。这些系统可以有不同的设置方式，但关于替代安排的影响的证据很少。数字化前门系统应有助于人们更好地获取服务，尤其是低强度服务（高强度护理可能需要全面的面对面评估）。
本研究旨在调查两种主要的数字化前门安排、官方网站上提供的易读信息和自我评估工具，与所提供的社会护理支持类型之间的关联：持续的低水平支持（OLLS）、短期护理（STC）和长期护理（LTC）。
2021年从152个英国地方当局的官方网站收集了有关前门安排的信息。我们使用地方当局层面官方政府报告中的汇总服务使用数据进行了横断面分析。自变量来自收集的政策信息，特别关注通过官方网站为成年人和照顾者提供在线数字化易读信息和自我评估工具的情况。因变量是不同年龄组使用社会护理支持的比率，包括OLLS、STC和LTC：成年人口（18岁及以上）、年轻人口（18至64岁）和老年人口（65岁及以上）。使用多元回归分析来检验数字化前门安排与获得社会护理支持之间的关联，并控制人口规模、依赖程度和经济需求因素。
不到20%（27/147）的地方当局将集成的数字化易读格式作为其数字化前门系统的一部分，约25%（37/147）在其系统中采用了数字化自我评估。我们发现，提供集成数字化易读信息格式的地方当局显示出更高的OLLS使用率（β系数=0.54；P=0.03；但与LTC和STC无统计学上的显著关联）。在1年（2021年）的横断面估计中，在线自我评估系统的提供与服务使用无关，但在分析2年（2020年和2021年）的服务使用数据时，发现与OLLS使用率有显著的正相关（β系数=0.41；P=0.21）。值得注意的是，这些发现在不同年龄组中是一致的。
这些发现与我们的假设一致，即具有内置易读和自我评估功能的数字系统可能会使人们更容易获得（低强度）服务。采用这些安排可能有助于增加符合条件者对支持的接受度，对他们与护理相关的幸福感产生预期的益处。鉴于英国地方当局对数字化前门的采用有限，扩大其使用可以改善与护理相关的结果并节省社会护理成本。
