The role of disability in explaining long-term care utilization

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Aging populations necessitate a deeper understanding of long-term care (LTC) service utilization.
• Identifying key determinants of LTC use is crucial for policy development and resource allocation.

Purpose of the Study:

• To examine the factors influencing the use of homecare and institutional long-term care services among middle-aged and elderly individuals in the Netherlands.
• To assess the impact of disability severity on the likelihood of utilizing different levels of LTC.

Main Methods:

• Pooled analysis of two cross-sectional surveys targeting individuals aged 50 and older.
• Disability measured through impairments in activities of daily living (ADL, iADL) and mobility.
• Ordered response model used to analyze LTC utilization, comparing separate disability indicators versus a composite disability index.

Main Results:

• Age and disability were identified as primary determinants of LTC use, with a composite disability index proving effective.
• The presence of any disability had a greater impact on utilization than multiple disabilities.
• Sex, living arrangements, psychological issues, and hospitalizations also significantly influenced LTC use, with varying effects on homecare versus institutional care.

Conclusions:

• Age remains a significant predictor of LTC use, even when controlling for disability.
• General health status demonstrated minimal impact on LTC utilization.
• The developed model and disability index offer a valuable tool for policy simulation and forecasting LTC needs.