TY - JOUR
T1 - Home health and informal care utilization and costs over time in Alzheimer's disease
AU - Zhu, Carolyn
AU - Torgan, Rebecca
AU - Scarmeas, Nikolaos
AU - Albert, Marilyn
AU - Brandt, Jason
AU - Blacker, Deborah
AU - Sano, Mary
AU - Stern, Yaakov
PY - 2008
Y1 - 2008
N2 - Objectives: To (1) compare home health and informal (unpaid) services utilization among patients with Alzheimer's disease (AD), (2) examine longitudinal changes in services use, and (3) estimate possible interdependence of home health and informal care utilization. Methods: The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed annually for up to 7 years in three university-based AD centers. Bivariate probit models estimated the effects of patient characteristics on home health and informal care utilization. Results: A large majority of the patients (80.6%) received informal care with a smaller proportion (18.6%) receiving home health services. Home health services utilization increased from 9.9% at baseline to 34.5% in year 4. Among users, number of days that services were provided in three-month recall increased from 21.9 to 56 days over time. Home health services utilization was significantly associated with function, depressive symptoms, being female, and not living with a spouse. Informal care utilization was significantly associated with cognition, function, comorbidities, and living with a spouse or child. Conclusions: Home health and informal care utilization relate differently to patient characteristics. Utilization of home health care or informal care was not influenced by utilization of the other.
AB - Objectives: To (1) compare home health and informal (unpaid) services utilization among patients with Alzheimer's disease (AD), (2) examine longitudinal changes in services use, and (3) estimate possible interdependence of home health and informal care utilization. Methods: The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed annually for up to 7 years in three university-based AD centers. Bivariate probit models estimated the effects of patient characteristics on home health and informal care utilization. Results: A large majority of the patients (80.6%) received informal care with a smaller proportion (18.6%) receiving home health services. Home health services utilization increased from 9.9% at baseline to 34.5% in year 4. Among users, number of days that services were provided in three-month recall increased from 21.9 to 56 days over time. Home health services utilization was significantly associated with function, depressive symptoms, being female, and not living with a spouse. Informal care utilization was significantly associated with cognition, function, comorbidities, and living with a spouse or child. Conclusions: Home health and informal care utilization relate differently to patient characteristics. Utilization of home health care or informal care was not influenced by utilization of the other.
KW - Cost
KW - Dementia
KW - Home health service
KW - Informal care
KW - Longitudinal study
UR - http://www.scopus.com/inward/record.url?scp=45549085609&partnerID=8YFLogxK
U2 - 10.1300/J027v27n01_01
DO - 10.1300/J027v27n01_01
M3 - Article
C2 - 18510196
AN - SCOPUS:45549085609
SN - 0162-1424
VL - 27
SP - 1
EP - 20
JO - Home Health Care Services Quarterly
JF - Home Health Care Services Quarterly
IS - 1
ER -