Journal article
Socioeconomic inequalities in home-care use across regional long-term care systems in Europe
- Abstract:
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Objectives
We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familization”).
Method We use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC.
Results We find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization.
Discussion The results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 183.7KB, Terms of use)
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- Publisher copy:
- 10.1093/geronb/gbaa139
Authors
- Publisher:
- Gerontological Society of America
- Journal:
- Journals of Gerontology Series B More from this journal
- Volume:
- 76
- Issue:
- 1
- Pages:
- 121-132
- Publication date:
- 2020-09-30
- Acceptance date:
- 2020-08-10
- DOI:
- EISSN:
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1758-5368
- ISSN:
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1079-5014
- Pmid:
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32996570
- Language:
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English
- Keywords:
- Pubs id:
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1158805
- Local pid:
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pubs:1158805
- Deposit date:
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2021-11-08
- ARK identifier:
Terms of use
- Copyright holder:
- Floridi et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected]. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/ licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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