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Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark.

https://arctichealth.org/en/permalink/ahliterature123849
Source
BMC Public Health. 2012;12:396
Publication Type
Article
Date
2012
Author
Yukari Yamada
Anette Ekmann
Charlotte Juul Nilsson
Mikkel Vass
Kirsten Avlund
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. yukari.yamada@upol.cz
Source
BMC Public Health. 2012;12:396
Date
2012
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Cross-Sectional Studies
Denmark
Female
Financing, Personal - economics - statistics & numerical data
Geriatric Assessment
Health Services for the Aged - economics
Healthcare Disparities - economics
Home Care Services - economics - utilization
House Calls - utilization
Humans
Logistic Models
Male
Patient Acceptance of Health Care - psychology - statistics & numerical data
Physicians, Family - education - standards
Prevalence
Preventive Health Services - economics - methods
Program Evaluation
Questionnaires
Residence Characteristics
Sex Distribution
Social Class
Abstract
Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association.
The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender.
Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0)). However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals.
High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.
Notes
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PubMed ID
22656647 View in PubMed
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Formal home help services and institutionalization.

https://arctichealth.org/en/permalink/ahliterature132916
Source
Arch Gerontol Geriatr. 2012 Mar-Apr;54(2):e52-6
Publication Type
Article
Author
Yukari Yamada
Volkert Siersma
Kirsten Avlund
Mikkel Vass
Author Affiliation
Section of Social Medicine, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, DK-1014, Copenhagen, Denmark. yuya@sund.ku.dk
Source
Arch Gerontol Geriatr. 2012 Mar-Apr;54(2):e52-6
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged - statistics & numerical data
Aged, 80 and over
Chi-Square Distribution
Denmark - epidemiology
Female
Home Care Services - statistics & numerical data
Housekeeping - statistics & numerical data
Humans
Independent Living - statistics & numerical data
Institutionalization - statistics & numerical data
Male
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Abstract
The effect of home help services has been inconsistent. Raising the hypothesis that receiving small amounts of home help may postpone or prevent institutionalization, the aim of the present study is to analyze how light and heavy use of home help services was related to the risk for institutionalization. The study was a secondary analysis of a Danish intervention study on preventive home visits in 34 municipalities from 1999 to 2003, including 2642 home-dwelling older people who were nondisabled and did not receive public home help services at baseline in 1999 and who lived at home 18 months after baseline. Cox regression analysis showed that those who received home help services during the first 18 months after baseline were at higher risk of being institutionalized during the subsequent three years than those who did not receive such services. However, receiving home help for less than 1h per week during the first 18 months after baseline was not associated with an increased risk of institutionalization during the study period among those with physical or mental decline. Receiving public home help services was a strong indicator for institutionalization in Denmark. Receiving small amounts of home help and experiencing physical or mental decline was not associated with higher hazard for institutionalization compared with those who received no help.
PubMed ID
21764144 View in PubMed
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