[Home care in deprived districts: what is the role of material wealth?]

To examine if there is a higher uptake of home care among residents of deprived districts and to determine if this can be attributed to the lower levels of income and wealth of these residents.

Retrospective, descriptive study.

The study focused on residents aged 50 and above. We obtained data on uptake of home care in 2007 from national care registries, which were combined with fiscal registry data on income and wealth. Postcode data were used to distinguish between 40 'deprived' districts and all other Dutch districts.

In the deprived districts more residents received home care than in other districts. This difference was greatest among residents aged 50 to 69 years. After correction for age, sex and country of origin, the difference was substantial (odds ratio (OR): 1.31). After correction for differences in income this difference was halved (OR: 1.17).The difference was further strongly reduced after correction for wealth (OR: 1.06). In deprived districts there was a higher uptake of domestic care (OR: 1.12) but the inverse was true for personal care (OR: 0.95). The latter was most marked in residents aged 80 and above (OR: 0.88).

The higher uptake of home care among residents of deprived districts can be attributed to low levels of income and wealth. In the Netherlands, changes in home care arrangements at national and local level should take into account people with financial problems and the districts in which they live.