TY - JOUR
T1 - Is there equity in initial access to formal dementia care in Europe?
T2 - The Andersen Model applied to the Actifcare cohort
AU - Kerpershoek, Liselot
AU - de Vugt, Marjolein
AU - Wolfs, Claire
AU - Orrell, Martin
AU - Woods, Bob
AU - Jelley, Hannah
AU - Meyer, Gabriele
AU - Bieber, Anja
AU - Stephan, Astrid
AU - Selbaek, Geir
AU - Michelet, Mona
AU - Wimo, Anders
AU - Handels, Ron
AU - Irving, Kate
AU - Hopper, Louise
AU - Goncalves-Pereira, Manuel
AU - Balsinha, Conceicao
AU - Zanetti, Orazio
AU - Portolani, Daniel
AU - Verhey, Frans
AU - ActifCare Consortium
N1 - Funding Information:
This is an EU Joint Programme—Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND— www.jpnd.eu . Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology, United Kingdom, Economic and Social Research Council.
Funding Information:
The project is supported through the following funding organizations under the aegis of JPND— www.jpnd.eu [grant number 733051001]. Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology (Fundação para a Ciência e Tecnologia [grant number FCT‐JPND‐HC/0001/2012], United Kingdom, Economic and Social Research Council. JPND has read and approved of the protocol of the Actifcare study.
Funding Information:
The project is supported through the following funding organizations under the aegis of JPND—www.jpnd.eu [grant number 733051001]. Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology (Fundação para a Ciência e Tecnologia [grant number FCT-JPND-HC/0001/2012], United Kingdom, Economic and Social Research Council. JPND has read and approved of the protocol of the Actifcare study. This is an EU Joint Programme—Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND—www.jpnd.eu. Germany, Ministry of Education and Research, Ireland, Health research board, Italy, Ministry of Health, the Netherlands, The Netherlands organization for Health Research and Development, Sweden, The Swedish Research Council for Health, Working Life and Welfare, Norway, The Research Council of Norway, Portugal, Foundation for Science and Technology, United Kingdom, Economic and Social Research Council.
Publisher Copyright:
© 2019 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.
PY - 2020/1
Y1 - 2020/1
N2 - ObjectivesIn the current study, the Anderson model is used to determine equitable access to dementia care in Europe. Predisposing, enabling, and need variables were investigated to find out whether there is equitable access to dementia-specific formal care services. Results can identify which specific factors should be a target to improve access.MethodsA total of 451 People with middle-stage dementia and their informal carers from eight European countries were included. At baseline, there was no use of formal care yet, but people were expected to start using formal care within the next year. Logistic regressions were carried out with one of four clusters of service use as dependent variables (home social care, home personal care, day care, admission). The independent variables (predisposing, enabling, and need variables) were added to the regression in blocks.ResultsThe most significant predictors for the different care clusters are disease severity, a higher sum of (un)met needs, hours spent on informal care, living alone, age, region of residence, and gender.ConclusionThe Andersen model provided for this cohort the insight that (besides need factors) the predisposing variables region of residence, gender, and age do play a role in finding access to care. In addition, it showed us that the numbers of hours spent on informal care, living alone, needs, and disease severity are also important predictors within the model's framework. Health care professionals should pay attention to these predisposing factors to ensure that they do not become barriers for those in need for care.
AB - ObjectivesIn the current study, the Anderson model is used to determine equitable access to dementia care in Europe. Predisposing, enabling, and need variables were investigated to find out whether there is equitable access to dementia-specific formal care services. Results can identify which specific factors should be a target to improve access.MethodsA total of 451 People with middle-stage dementia and their informal carers from eight European countries were included. At baseline, there was no use of formal care yet, but people were expected to start using formal care within the next year. Logistic regressions were carried out with one of four clusters of service use as dependent variables (home social care, home personal care, day care, admission). The independent variables (predisposing, enabling, and need variables) were added to the regression in blocks.ResultsThe most significant predictors for the different care clusters are disease severity, a higher sum of (un)met needs, hours spent on informal care, living alone, age, region of residence, and gender.ConclusionThe Andersen model provided for this cohort the insight that (besides need factors) the predisposing variables region of residence, gender, and age do play a role in finding access to care. In addition, it showed us that the numbers of hours spent on informal care, living alone, needs, and disease severity are also important predictors within the model's framework. Health care professionals should pay attention to these predisposing factors to ensure that they do not become barriers for those in need for care.
KW - access to care
KW - Andersen model
KW - equity
KW - middle-stage dementia
KW - service use
KW - QUALITY-OF-LIFE
KW - INFORMAL CARE
KW - MEDICAL-CARE
KW - HEALTH-CARE
KW - PEOPLE
KW - SERVICES
KW - INSTITUTIONALIZATION
KW - PREDICTORS
KW - CAREGIVERS
KW - HOME
U2 - 10.1002/gps.5213
DO - 10.1002/gps.5213
M3 - Article
C2 - 31647572
SN - 0885-6230
VL - 35
SP - 45
EP - 52
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
IS - 1
ER -