[Factors influencing the utilization of visiting nursing and home-help services]

To identify the respective characteristics of clients using visiting nursing service and home-help service. Since the past, research on the utilization of in-home care services has usually focused on different services collectively.

Interviews using structured questionnaires were carried out with 134 elderly individuals who were selected in October 1997 from the list for home visit of public health nurses in a town with a population of 36,000. With regard to the utilization of visiting nursing as well as home-help service, the relationship with three factors of the conceptual Andersen's model (predisposing factor, needs factor, enabling factor) were examined.

Of the 134 subjects, 38.1% utilized visiting nursing service and 36.6% used home-help services. Use of visiting nursing service was significantly associated with variables such as declining ADL in the elderly, hospitalization within the past two years, less caregiving by family members, and less resistance to service-use by caregivers. On the other hand, use of home help service was related to less caregiving by family members and resources of visiting nursing. The clients who used both visiting nursing and home-help service had more difficulty with caregiving by family members compared to those who used only nursing service, and the latter were inferior in them of physical conditions, including ADL, to those who employed only home-helpers.

The factors promoting the use of visiting nursing are different to some extent from those for home-help service. Clients using both are characterized by the presence of a broader variety needs.