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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)
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
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
Language
english
Publication Year
2021
HGF-reported in Year
2021
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
Reviewing status
Peer reviewed
Institute(s)
Institute of Health Economics and Health Care Management (IGM)
Institute of Epidemiology (EPI)
Institute of Epidemiology (EPI)
POF-Topic(s)
30202 - Environmental Health
80000 - German Center for Lung Research
80000 - German Center for Lung Research
Research field(s)
Genetics and Epidemiology
PSP Element(s)
G-505300-002
G-501800-533
G-505300-001
G-504000-010
G-504090-001
G-501800-533
G-505300-001
G-504000-010
G-504090-001
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
State of Bavaria
Helmholtz Zentrum Munchen - German Research Center for Environmental Health - German Federal Ministry of Education and Research
WOS ID
WOS:000688453300006
Scopus ID
85111672250
PubMed ID
34332058
Erfassungsdatum
2021-09-16