Santini Sara, Busilacchi Gianluca, Lamura Giovanni, Sofritti Federico, Pacifico Antonio, Bongelli Ramona, Guarascio Carmela
Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Italy.
Department of Economics and Law, University of Macerata, Macerata, Italy.
Front Public Health. 2025 Apr 28;13:1575330. doi: 10.3389/fpubh.2025.1575330. eCollection 2025.
In Italy, population ageing is causing an unprecedented demand for long-term care (LTC) services, that led to the recent national reform of the LTC system (Law n. 33/2023). Since LTC services are provided by regional authorities, identifying drivers of and barriers to their use by older people and their family caregivers locally is very important to identify the mismatch between national regulation and local demand of these services.
To this purpose, in 2019-2020, 450 family caregiver (FC)-older care recipient (OCR) dyads from 13 healthcare districts of the Marche region (Central Italy) were surveyed. A Two-step Bayesian Multiclass procedure was used for the analysis. The main drivers of the use of healthcare services are FC's age and gender (being a man), and OCR's age and level of disability.
The main barrier to the use of private services is their cost, while for the public ones is their unavailability. The most common private service is represented by migrant care workers (MCWs), hired privately by the older people's families.
Findings suggest that the recent national LTC reform in Italy does not seem to have fully captured the LTC needs of older people, and some policy suggestions are therefore provided in this regard.
在意大利，人口老龄化正导致对长期护理（LTC）服务的需求达到前所未有的程度，这促使近期对长期护理体系进行了全国性改革（第33/2023号法律）。由于长期护理服务由地方当局提供，在当地确定老年人及其家庭照料者使用这些服务的驱动因素和障碍，对于识别国家法规与这些服务的地方需求之间的不匹配非常重要。
为此，在2019 - 2020年期间，对意大利中部马尔凯地区13个医疗保健区的450对家庭照料者（FC） - 老年护理接受者（OCR）进行了调查。采用两步贝叶斯多分类程序进行分析。使用医疗保健服务的主要驱动因素是家庭照料者的年龄和性别（男性），以及老年护理接受者的年龄和残疾程度。
使用私人服务的主要障碍是其成本，而使用公共服务的主要障碍是无法获得。最常见的私人服务是由老年人家庭私下雇佣的移民护理工（MCW）。
研究结果表明，意大利近期的全国长期护理改革似乎并未充分满足老年人的长期护理需求，因此在这方面提出了一些政策建议。
