Functional disability and utilisation of long-term care in the older population in England: a dual trajectory analysis.

This study investigates the developmental trajectories of long-term care needs and utilisation in older people aged 65 years and over in England. The data came from the English Longitudinal Survey of Ageing (ELSA, waves 6–9, 2012–2018, N = 13,425). We conducted dual trajectory analyses to cluster pe...

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Publicado en:European Journal of Ageing Vol. 19; no. 4; pp. 1363 - 1374
Autores principales: Hu, Bo, Cartagena-Farias, Javiera, Brimblecombe, Nicola
Formato: Artículo
Publicado: Springer Nature Dec2022
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2022
      vid: 19
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      pub: Springer Nature
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        160646088
        10.1007/s10433-022-00723-0
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        atl: Functional disability and utilisation of long-term care in the older population in England: a dual trajectory analysis.
      aug:
        au:
          Hu, Bo
          Cartagena-Farias, Javiera
          Brimblecombe, Nicola
        affil: Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, Clement's Inn, WC2A 2AE, London, UK
      su:
        England
        Sex distribution
        Older people with disabilities
        Health equity
        Medical care use
        Descriptive statistics
        Long-term health care
        Medical needs assessment
      sug:
        subj:
          Sex distribution
          Older people with disabilities
          Health equity
          England
          Medical care use
          Descriptive statistics
          Long-term health care
          Medical needs assessment
      keyword:
        Care inequality
        Dual trajectory analysis
        Health inequality
        Long-term care
        Care inequality
        Dual trajectory analysis
        Health inequality
        Long-term care
      ab: This study investigates the developmental trajectories of long-term care needs and utilisation in older people aged 65 years and over in England. The data came from the English Longitudinal Survey of Ageing (ELSA, waves 6–9, 2012–2018, N = 13,425). We conducted dual trajectory analyses to cluster people's trajectories of care needs (measured by functional disability) and utilisation into distinct groups. We conducted logistic regression analyses to identify the factors associated with trajectory memberships. We identified three trajectories of long-term needs (low, medium, and high) and three trajectories of care utilisation (low, medium, and high). Both care needs and care hours increased with age, but the speed of increase varied by trajectory. Females, minority ethnic groups, people with low wealth, and those experiencing housing problems were more likely to follow the joint trajectories characterised by higher care needs and higher care intensity. People with low or medium care needs stayed in the same trajectories of care utilisation. In contrast, people in the high-needs trajectory followed divergent trajectories of care utilisation: 63% of them followed the trajectory of high care intensity and the rest (37%) followed the trajectory of medium care intensity. Lack of spouse care was the leading predictor of trajectory divergence (OR = 3.57, p < 0.001). Trajectories of care needs and utilisation are highly heterogeneous in later life, which indicates persistent inequalities over time. Single people with multiple functional limitations face an acute and enduring risk of inadequate care and unmet needs. The amount of support is as important as the availability of support.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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