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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Andrea Brassard, DNSc, MPH, RN, Columbia University, School of Nursing, New York, NY 10032, (973)633-9644, AndreaDNSc@aol.com
Purpose: To describe predictors and outcomes of home care use in an ethnically diverse sample of urban elders. Methods: Secondary data analysis of the Washington Heights-Inwood Columbia Aging Project (WHICAP) sample of 2128 elders, 410 of whom received home care at the 1992 baseline. Results: The study took place in the service rich environment of New York City. WHICAP home care recipients received on average forty hours of home care per week. Factors other than functional status which predicted home care use were increasing age, female gender, Medicaid coverage, and hospitalization. Household size was inversely related to home care use. Similarly, elders who lived with a spouse or an adult child were less likely to receive home care than elders who lived alone or lived with someone other than a spouse or adult child. Two outcomes of home care use were examined - survival and nursing home entry. Home care users as a group had significantly shorter rates of survival, but these differences were related to functional impairment. Regarding nursing home entry, less impaired home care users entered a nursing home more quickly than non-users, but nursing home entry was delayed for the most impaired home care users, compared to functionally impaired non-users. However, any differences between home care users and non-users were eliminated when controlling for functional status. Conclusions: The outcomes that this dissertation sought to measure, improved survival and delayed nursing home entry, may be unattainable goals of formal home care, no matter how many hours are provided.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.