Multilevel Analysis of Formal & Informal Care in Sweden

形式的多层次分析

• 批准号: 6898722
• 负责人: ADAM DAVEY
• 金额: $ 3.96万
• 依托单位: POLISHER RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-15 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6898722
• 关键词: Scandinavian country; aging; health care service utilization; health disparity; health economics; home health care; human data; longitudinal human study; mathematical model; medically underserved population; outpatient care; socioeconomics; statistics /biometry

24. Improved Measures and Methodologies. Past models of formal and informal care have focused on either the individual or macro level. As such, they have tended to ignore the role of supply-side and demand-side characteristics at the regional level or the individual-level availability of care needs and potential supports. By explicitly linking these two levels of data for two different time points, it is 3ossible to investigate how regional characteristics affect the extent and type of supports received by the individuals within them. The proposed pilot research will link individual and regional level data on formal and informal care systems in Sweden, a country which serves as an excellent starting 3oint for understanding health disparities and ethnocultural variation in care. The project aims first to identify regional demographic and formal care characteristics that are associated with formal and informal supports to older adults and rates of unmet need. A second aim is to determine whether longitudinal changes in demographic characteristics and availability of formal services have differentially affected women, the oldest old, those with little available kin support, and those with greatest functional impairment. Multilevel models will be used to address the study aims by linking statistics for 212 of Sweden's 289 municipalities with nationally representative individual data from these municipalities in 1994 (N = 1379) and 2000 (N = 1466). Levels of home help services have decreased in Sweden over this period while the older population in Sweden grows increasingly old and frail. This provides an ideal opportunity to examine how municipal level changes in home help services and demographic characteristics have affected the balance of ADL assistance that frail older Swedes receive from formal and informal sources and any resulting changes in rates of unmet need for assistance. Better understanding of the relation between formal and informal care systems has important implications for planning and design of services, and for finding more effective ways to support and sustain older adults and their families within the community.

24. 改进措施和方法。过去的正式和非正式护理模式要么集中在个人层面，要么集中在宏观层面。因此，它们往往忽视了区域一级供给侧和需求侧特征的作用，或忽视了个人一级护理需求和潜在支持的可得性。通过明确地将两个不同时间点的这两个级别的数据联系起来，就有可能调查区域特征如何影响其中个人所获得的支持的程度和类型。拟议的试点研究将把瑞典正式和非正式保健系统的个人和区域一级数据联系起来，瑞典是了解保健方面的健康差异和种族文化差异的一个很好的起点。该项目的目的首先是确定与对老年人的正式和非正式支助以及未满足需求的比率有关的区域人口和正式护理特征。第二个目的是确定人口特征的纵向变化和正式服务的可得性是否对妇女、最年长的老人、几乎没有亲属支持的人和功能受损最严重的人有不同的影响。多层模型将用于解决研究目标，将瑞典289个城市中的212个的统计数据与这些城市1994年（N = 1379）和2000年（N = 1466）具有全国代表性的个人数据联系起来。在此期间，瑞典的家政服务水平有所下降，而瑞典的老年人口越来越老，越来越虚弱。这提供了一个理想的机会来研究市政层面的家政服务和人口特征的变化如何影响那些脆弱的ADL援助的平衡