Rural–Urban Disparities in In‐Home Care Journeys in Sparsely Populated Areas: A Case From Northern Sweden.

This paper investigates rural–urban disparities in the experiences of in‐home care services for older adults in a sparsely populated municipality (Storuman) in Northern Sweden. Such municipalities are characterised by long‐term population loss and ageing, an increasing concentration of residents and...

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Publicado en:Health & Social Care in the Community Vol. 2025; pp. 1 - 14
Autores principales: Carson, Dean Bradley, Carson, Doris Anna, Mude, William, Basu Roy, Sohini
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell 9/27/2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Rural–Urban Disparities in In‐Home Care Journeys in Sparsely Populated Areas: A Case From Northern Sweden.
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        au:
          Carson, Dean Bradley
          Carson, Doris Anna
          Mude, William
          Basu Roy, Sohini
        affil: Department of Epidemiology and Global Health,, Umeå University,, Umeå, SE-90187,, Sweden, umu.se
      sug:
        subj:
          Home Health Care In Old Age
          Rural Health
          Urban Health
          Healthcare Disparities In Old Age
          Health Services for Older Persons
          Health Services Accessibility
          Outcomes (Health Care)
          Sweden
          Human
          Female
          Male
          Aged
          Aged, 80 and Over
          Rural Population
          Urban Population
          Residence Characteristics
          Survival Analysis
          Residential Care
          Urbanization
          Grocery Stores
          Health Resource Utilization
          Transfer, Discharge
          Logistic Regression
          Prospective Studies
          Sex Factors
          Funding Source
          Health Care Delivery
          Confidence Intervals
          Descriptive Statistics
          Social Determinants of Health
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: This paper investigates rural–urban disparities in the experiences of in‐home care services for older adults in a sparsely populated municipality (Storuman) in Northern Sweden. Such municipalities are characterised by long‐term population loss and ageing, an increasing concentration of residents and services in municipal centres and resultant rural 'resource deserts'. Disparities are measured through four 'endpoint' measures—exits to residential care, resource use, longevity and survival in the in‐home care system. Data were drawn from the municipality's care service contract database (2014–2020). Users living in the municipal centre had lower resource use and used direct care less frequently than those in smaller and more distant settlements. Those living near a grocery store were more likely than others to survive long term in the in‐home care system. The research reveals a potential to reduce exits to residential care, to make more effective use of direct care and shopping services and to limit disruptive transfers of care, particularly between municipal and regional health services. Overall, there was limited evidence of rural–urban disparities in in‐home care outcomes, but particular attention should be paid to transactional proximity of different parts of the care system and proactive rather than reactive care planning. The paper contributes to debates about quality measures for in‐home care and the impacts of micro‐urbanisation on the lives of people living in sparsely populated areas.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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