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Steinbeisser, K. ; Schwarzkopf, L. ; Grill, E.* ; Schwettmann, L. ; Peters, A. ; Seidl, H.

Gender-linked determinants for utilization of long-term care in community-dwelling adults 65+ in Germany: Results from the population-based KORA-Age study.

Exp. Gerontol. 153:111500 (2021)

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Open Access Green as soon as Postprint is submitted to ZB.

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BACKGROUND: The number of people using long-term care (LTC) is increasing steadily, hence, demand for adequate services is rising. The purpose of this exploratory study was to identify relevant gender-linked determinants for utilization of LTC in community-dwelling older adults. METHODS: We examined 4077 females (52.7%) and males ≥ 65 years old (range: 65-97 years) between 2011/12 (t₁) and 2016 (t₂). Data originated from the population-based Cooperative Health Research in the Region of Augsburg (KORA)-Age study in southern Germany. A descriptive analysis assessed the amount of LTC used. Cross-sectional generalized estimating equation logistic models identified determinants for utilization of (in)formal LTC. Determinants for transition to LTC between t₁ and t₂ were examined using a longitudinal logistic regression model. Potential determinants were chosen according to Andersen's Behavioral Model of Health Services Use. RESULTS: At t₂, 820 (20.1%) were LTC users with 527 (64.3%) being female. The average amount of informal LTC was higher in males, whereas the amount of formal LTC was higher in females. In both genders, higher age, multimorbidity, and disability were associated with utilization of and transition to LTC. Living alone was significantly associated with utilization of LTC in both genders, but its effect was two times stronger in males. Thus, it is considered the essential gender-linked determinant. CONCLUSIONS: Gender-linked determinants must be considered when establishing demand-oriented policies. Future health programs should specifically target older individuals, especially males, living alone to improve their capabilities in activities of daily living to allow them to remain living longer and independently within community settings.

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Publication type Article: Journal article

Document type Scientific Article

Corresponding Author

Keywords Gender ; Gender-linked Determinants ; Generalized Estimating Equations ; Health Care Utilization ; Long-term Care ; Sex; Time Spent; Older Ages; Home Care; Health; Disability; Services; Receipt

ISSN (print) / ISBN 0531-5565

e-ISSN 0531-5565

Journal Experimental Gerontology

Quellenangaben Volume: 153, Article Number: 111500

Publisher Elsevier

Publishing Place The Boulevard, Langford Lane, Kidlington, Oxford Ox5 1gb, England

Non-patent literature Publications

Reviewing status Peer reviewed

Institute(s) Institute of Health Economics and Health Care Management (IGM)
Institute of Epidemiology II (EPI2)

Grants German Federal Ministry of Education and Research (BMBF)
State of Bavaria
Helmholtz Zentrum Munchen - German Research Center for Environmental Health - German Federal Ministry of Education and Research