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Multilevel Analysis of Formal & Informal Care in Sweden

形式的多层次分析

基本信息

批准号：
7347212
负责人：
ADAM DAVEY
金额：
$ 2.71万
依托单位：
TEMPLE UNIV OF THE COMMONWEALTH
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-06-15 至 2007-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7347212
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

项目摘要

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侧重于个人或宏观层面。因此，它们往往忽视区域一级的供应方和需求方特征的作用或个人一级提供护理需求和潜在支助的情况。通过明确地将两个不同时间点的这两个水平的数据联系起来，可以调查地区特征如何影响其中个人获得支持的程度和类型。拟议的试点研究将把瑞典正规和非正规护理系统的个人和区域数据联系起来，瑞典是了解保健方面的健康差距和民族文化差异的极佳起点。该项目旨在首先确定与对老年人的正式和非正式支助有关的区域人口和正规护理特点以及未得到满足的需求率。第二个目标是确定人口特征和正规服务可获得性的纵向变化是否对妇女、年龄最大的老年人、几乎没有亲属支持的妇女和功能损害最严重的妇女产生了不同的影响。将使用多级模型将瑞典289个市镇中212个市镇的统计数据与这些市镇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，瑞典的家务助理服务水平有所下降，而瑞典的老年人口变得越来越老和虚弱。这提供了一个理想的机会来研究市政层面家务助理服务和人口特征的变化如何影响脆弱的ADL援助的平衡年长的瑞典人从正式和非正式来源获得援助，以及任何由此导致的未得到满足的援助需求率的变化。更好地了解正规和非正规护理系统之间的关系，对于规划和设计服务，以及寻找更有效的方式在社区内支持和维持老年人及其家人具有重要意义。