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  • Individual and Contextual D...
    Hlebec, Valentina

    Zdravstveno varstvo, 12/2014, Volume: 53, Issue: 4
    Journal Article

    Theory. Social homecare is important for older people, as it enables them to remain in their own homes during worsening health, thus relieving the burden on institutional facilities such as homes for the elderly or nursing homes and hospitals. Method. A representative survey of social homecare users was employed to assess determinants of the scope of social homecare in Slovenia. Multiple regression analysis was used to evaluate determinants defined by Andersen’s behavioral model that affect the scope of social homecare. Results. As expected, need (Functional impairment B = .378, P = 0.000) was the most important explanatory component, followed by availability of informal care network (Lives alone B = -.136, P = 0.000; Has children B = - .142; P = 0.000) and other contextual factors such as total costs of the services (B = -.075; P = 0.003) and temporal availability of services (B=-.075, P=0.012). The model explained 18% of variability in the scope of social homecare. Conclusion. This study showed that data on the individual level, as opposed to data on an aggregated level, show different determinants of social homecare utilization. Moreover, the results showed that social homecare is especially important in two circumstances: when older people have a high level of need and when they do not have access to informal care networks. Contextual factors had a moderate effect on the scope of social homecare, which shows universal access to the latter at the individual level. Teoretična izhodišča. Socialna oskrba na domu je pomembna storitev za starejše z zdravstvenimi težavami, prebivajoče v domačem okolju. Ob zagotavljanju boljše kakovosti življenja ta storitev pomembno razbremenjuje institucionalne storitve zdravstvenega in socialnovarstvenega sistema. Metoda. Na podatkih reprezentativne raziskave uporabnikov socialne oskrbe na domu smo raziskali vpliv teh dejavnikov na obseg socialne oskrbe na domu. Z multiplo regresijsko analizo smo ugotovili vpliv dispozicijskih in kontekstualnih dejavnikov ter potreb na število aktivnosti, pri katerih uporabnikom pomagajo socialne oskrbovalke. Rezultati. Kot predpostavlja teoretski model, potrebe (B = ,378, P = 0,000) pojasnijo največji del variabilnosti obsega socialne oskrbe na domu. Po pojasnjevalni moči sledijo razpoložljivost neformalnih oskrbovalcev(živi sam B = -0,136, P = 0,000; ima otroke B = -0,142; P = 0,000) ter drugi kontekstualni dejavniki, kot so skupni stroški ure oskrbe(B = -0,075; P = 0,003) in časovna razpoložljivost socialne oskrbe na domu(B= -0,075, P=0,012). Končni model pojasni 18% obsega socialne oskrbe na domu. Razprava. Dokazali smo, da na individualni ravni na uporabo socialne oskrbe na domu vplivajo drugi dejavniki kot na agregirani ravni. Socialna oskrba na domu je najpomembnejša ob veliki potrebi po oskrbi in odsotnosti neformalnih oskrbovalcev. Zmeren vpliv kontekstualnih dejavnikov nakazuje sorazmerno enakomeren dostop do socialne oskrbe na domu.