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Long-term care use after a stroke or femoral fracture and the role of family caregivers

Authors
  • van der Burg, Doutsen A.1
  • Diepstraten, Maaike2
  • Wouterse, Bram3
  • 1 The Dutch Healthcare Authority (NZA), Utrecht, The Netherlands , Utrecht (Netherlands)
  • 2 The Netherlands Bureau for Economic Policy Analysis (CPB), The Hague, The Netherlands , The Hague (Netherlands)
  • 3 Erasmus University Rotterdam, P.O. Box 1738, Rotterdam, DR, 3000, The Netherlands , Rotterdam (Netherlands)
Type
Published Article
Journal
BMC Geriatrics
Publisher
BioMed Central
Publication Date
Apr 22, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12877-020-01526-7
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThere has been a shift from institutional care towards home care, and from formal to informal care to contain long-term care (LTC) costs in many countries. However, substitution to home care or informal care might be harder to achieve for some conditions than for others. Therefore, insight is needed in differences in LTC use, and the role of potential informal care givers, across specific conditions. We analyze differences in LTC use of previously independent older patients after a fracture of femur and stroke, and in particular examine to what extent having a partner and children affects LTC use for these conditions.MethodsUsing administrative data on Dutch previously independent older people (55+) with a fracture of femur or stroke in 2013, we investigate their LTC use in the year after the condition takes place. We use administrative treatment data to select individuals who were treated by a medical specialist for a stroke or femoral fracture in 2013. Subsequent LTC use is measured as using no formal care, home care, institutional care or being deceased at 13 consecutive four-weekly periods after initial treatment. We relate long-term care use to having a partner, having children, other personal characteristics and the living environment.ResultsThe probability to use no formal care 1 year after the initial treatment is equally high for both conditions, but patients with a fracture are more likely to use home care, while patients with a stroke are more likely to use institutional care or have died. Having a spouse has a negative effect on home care and institutional care use, but the timing of the effect, especially for institutional care, differs strongly between the two conditions. Having children also has a negative effect on formal care use, and this effect is consistently larger for patients with a fracture than patients with a stroke.ConclusionAs the condition and the effect of potential informal care givers matter for subsequent long-term care use, policy makers should take the expected prevalence of specific conditions within the older people population into account when designing long-term care policies.

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