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Factors associated with perceived unmet needs for home support in home dwelling older adults in the Swiss context: a population study

Author:

Maria Mendieta

Institute of Nursing Science, University of Basel, Switzerland Department of Public Health and Primary Care, Patient Related and Public Health Research, KU Leuven, CH
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Abstract

Introduction: Unmet needs for home support in home-dwelling older adults occur when needed services are not being received, or are insufficient to meet their needs for support to perform the following:  activities of daily living, instrumental activities of daily living, transportation, and basic maintenance. Not meeting those needs can negatively impact older adults’ quality of life, and increase health care utilization, hospitalizations, institutionalizations, or death. To date there is no consensus in how to assess these unmet needs.  In parallel, previous research of factors associated with unmet needs for home support has mostly focused on factors at the individual level

Aim and Methods: Guided by the Integrated Care for Older People Implementation Framework and the Andersen Behavioral Model, we aimed to identify factors at the macro, meso and micro levels associated with the presence of unmet needs for home support among home-dwelling older population (aged 75+) in Switzerland.

This is a secondary cross-sectional analysis of the INSPIRE Population Survey of home-dwelling older adults (n=8,508) living in Basel-Landschaft in Switzerland. Prevalence of perceived unmet needs for home support was self-reported, using a dichotomized question. Multiple logistic regression analyses were performed to investigate the associations of factors at each level with unmet needs for home support. 

Results: 4.3% of participants reported unmet needs for home support. The median age of participants was 81 years. 45.1% had private health insurance and 6.3% needed additional government support. Being a recipient of other type of government support (macro-) [OR=1.65; IC=1.17 - 2.29]; the use of transportation services (meso-) [OR=1.68; IC=1.11 - 2.48]; and feeling depressed [OR=1.40; IC=1.06 - 1.85] or abandoned [OR=2.60; IC=1.96 - 3.43] (micro-) increased odds of having perceived unmet needs for home support. On the other hand, having a private health insurance [OR= 0.63; IC=0.49-0.80] (macro-) was associated with decreased odds of having perceived unmet needs for home support, as well as the following micro level factors: speaking Swiss-German or German as mother tongue, having a level of education above primary, keeping an optimal physical activity, having a problematic alcohol consumption, having a high score of self-perceived health status and having informal care.

Conclusions: Our study findings add to existing knowledge that in addition to the factors at the micro level, the perception of unmet needs for home support in home-dwelling older adults is also influenced by factors at the macro and meso levels, and thus supporting the use of an ecological approach in the analysis.  

Implications and limitations: Adaptations to the current pension and health insurance system should be considered to reach vulnerable older adults and reduce the variation in the access to home support services. As we used secondary data, a better assessment of the perception of unmet needs in home-dwelling older adults could not be obtained.

 

 

How to Cite: Mendieta M. Factors associated with perceived unmet needs for home support in home dwelling older adults in the Swiss context: a population study. International Journal of Integrated Care. 2022;22(S3):259. DOI: http://doi.org/10.5334/ijic.ICIC22129
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Published on 04 Nov 2022.

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