Abstract
OBJECTIVES. The purpose of this study was to compare the national prevalences and predictors of paid in-home functional assistance among disabled Latino and non-Latino elderly people who receive such assistance. METHODS. Data were derived from the 1988 wave of the National Center for Health Statistics Longitudinal Study on Aging and the 1988 Commonwealth Fund Commission Survey of Elderly Hispanics. Logistic regression was used to model paid care use and to calculate estimated probabilities of such use. RESULTS. Among Latino and non-Latino Whites 74 years of age and older who received functional assistance, similar proportions used paid assistance. Predictors of paid care coincided with established models for non-Latino Whites only. Disabled Latinos had a lower estimated probability of using paid assistance when they were highly disabled and socially isolated but had a higher estimated probability when their children lived nearby. CONCLUSIONS. The effects of disability and social support differ among non-Latino White and Latino elderly people. Latino elderly people with high anticipated needs obtain less paid assistance than similar non-Latino Whites. In addition to a reduction in financial barriers, improving access to long-term care services requires addressing this diversity in service use patterns.
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Selected References
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- Branch L. G., Wetle T. T., Scherr P. A., Cook N. R., Evans D. A., Hebert L. E., Masland E. N., Keough M. E., Taylor J. O. A prospective study of incident comprehensive medical home care use among the elderly. Am J Public Health. 1988 Mar;78(3):255–259. doi: 10.2105/ajph.78.3.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cantor M. H. Strain among caregivers: a study of experience in the United States. Gerontologist. 1983 Dec;23(6):597–604. doi: 10.1093/geront/23.6.597. [DOI] [PubMed] [Google Scholar]
- Edelman P., Hughes S. The impact of community care on provision of informal care to homebound elderly persons. J Gerontol. 1990 Mar;45(2):S74–S84. doi: 10.1093/geronj/45.2.s74. [DOI] [PubMed] [Google Scholar]
- Hanley R. J., Alecxih L. M., Wiener J. M., Kennell D. L. Predicting elderly nursing home admissions. Results from the 1982-1984 National Long-Term Care Survey. Res Aging. 1990 Jun;12(2):199–228. doi: 10.1177/0164027590122004. [DOI] [PubMed] [Google Scholar]
- Hanley R. J., Wiener J. M., Harris K. M. Will paid home care erode informal support? J Health Polit Policy Law. 1991 Fall;16(3):507–521. [PubMed] [Google Scholar]
- Hosmer D. W., Taber S., Lemeshow S. The importance of assessing the fit of logistic regression models: a case study. Am J Public Health. 1991 Dec;81(12):1630–1635. doi: 10.2105/ajph.81.12.1630. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jones E. W., Densen P. M., Brown S. D. Posthospital needs of elderly people at home: findings from an eight-month follow-up study. Health Serv Res. 1989 Dec;24(5):643–664. [PMC free article] [PubMed] [Google Scholar]
- KATZ S., FORD A. B., MOSKOWITZ R. W., JACKSON B. A., JAFFE M. W. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914–919. doi: 10.1001/jama.1963.03060120024016. [DOI] [PubMed] [Google Scholar]
- Kemper P. The use of formal and informal home care by the disabled elderly. Health Serv Res. 1992 Oct;27(4):421–451. [PMC free article] [PubMed] [Google Scholar]
- Lawton M. P., Brody E. M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed] [Google Scholar]
- McAuley W. J., Arling G. Use of in-home care by very old people. J Health Soc Behav. 1984 Mar;25(1):54–64. [PubMed] [Google Scholar]
- Shanas E. The family as a social support system in old age. Gerontologist. 1979 Apr;19(2):169–174. doi: 10.1093/geront/19.2.169. [DOI] [PubMed] [Google Scholar]
- Soldo B. J. In-home services for the dependent elderly. Determinants of current use and implications for future demand. Res Aging. 1985 Jun;7(2):281–304. doi: 10.1177/0164027585007002007. [DOI] [PubMed] [Google Scholar]
- Spector W. D., Kemper P. Disability and cognitive impairment criteria: targeting those who need the most home care. Gerontologist. 1994 Oct;34(5):640–651. doi: 10.1093/geront/34.5.640. [DOI] [PubMed] [Google Scholar]
- Stoller E. P., Cutler S. J. Predictors of use of paid help among older people living in the community. Gerontologist. 1993 Feb;33(1):31–40. doi: 10.1093/geront/33.1.31. [DOI] [PubMed] [Google Scholar]
- Tennstedt S. L., Crawford S. L., McKinlay J. B. Is family care on the decline? A longitudinal investigation of the substitution of formal long-term care services for informal care. Milbank Q. 1993;71(4):601–624. [PubMed] [Google Scholar]
- Tennstedt S. L., Crawford S., McKinlay J. B. Determining the pattern of community care: is coresidence more important than caregiver relationship? J Gerontol. 1993 Mar;48(2):S74–S83. doi: 10.1093/geronj/48.2.s74. [DOI] [PubMed] [Google Scholar]
- Wallace S. P., Campbell K., Lew-Ting C. Y. Structural barriers to the use of formal in-home services by elderly Latinos. J Gerontol. 1994 Sep;49(5):S253–S263. doi: 10.1093/geronj/49.5.s253. [DOI] [PubMed] [Google Scholar]
- Wallace S. P., Lew-Ting C. Y. Getting by at home. Community-based long-term care of Latino elders. West J Med. 1992 Sep;157(3):337–344. [PMC free article] [PubMed] [Google Scholar]
- Weissert W. G., Cready C. M. Toward a model for improved targeting of aged at risk of institutionalization. Health Serv Res. 1989 Oct;24(4):485–510. [PMC free article] [PubMed] [Google Scholar]
- Wolinsky F. D., Johnson R. J. The use of health services by older adults. J Gerontol. 1991 Nov;46(6):S345–S357. doi: 10.1093/geronj/46.6.s345. [DOI] [PubMed] [Google Scholar]
- Yeatts D. E., Crow T., Folts E. Service use among low-income minority elderly: strategies for overcoming barriers. Gerontologist. 1992 Feb;32(1):24–32. doi: 10.1093/geront/32.1.24. [DOI] [PubMed] [Google Scholar]
