Factors influencing use of home care and nursing homes

Journal of Advanced Nursing 54(4), 511–517Factors influencing use of home care and nursing homesAim. This paper reports a study comparing the characteristics of patients who usehome care services and those who are cared for in nursing homes, and identifyingthe factors that influence the use of these care settings.Background. The increase in the functionally dependent older population has led toan increase in the number of nursing homes and home care agencies. It has becomeclear that, rather than disputing which is the better of these options, it would bebetter to determine the characteristics of patients who use the two long-term careservices. Gaining an understanding of the unique characteristics of patients who arecared for by home care agencies and those who are cared for in nursing homes willbe imperative for reforming and developing long-term care systems.Method. The research model was based on the Anderson Model of Health ServicesUtilization. Interviews were conducted with 99 stroke survivors from two home careagencies and four nursing homes, and their family members, between May andDecember 2001.Results. The patient characteristics that predicted greater use of home care ratherthan nursing home services were: being married, poor physical function, impairedcognitive function, higher rates of comorbidity, various medical complications, and/or number of catheters (e.g. urinary catheter, naso-gastric tube).Conclusion. Contrary to the findings of previous studies conducted in countries withageing populations, our findings indicate that in South Korea home care agencies,rather than nursing homes, provide care for severely impaired patients. This may bedue to differences between countries in their long-term care systems and culturalattitudes toward end-of-life care. Our results will contribute to the development orreformation of long-term care systems in countries with ageing populations, and tothe development of strategies for increasing access to these services.Keywords: empirical research report, health services utilization, home care, inter-views, long-term care, nursing homes, older people