Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts

Elżbieta W Buczak-Stec; André Hajek; Alexander Pabst; Christian Brettschneider; Hendrik van den Bussche; Birgitt Wiese; Siegfried Weyerer; Jochen Werle; Andreas Hoell; Michael Pentzek; Angela Fuchs; Melanie Luppa; Margit Löbner; Janine Stein; Franziska Förster; Dagmar Weeg; Edelgard Mösch; Kathrin Heser; Martin Scherer; Wolfgang Maier; Matthias C Angermeyer; Michael Wagner; Steffi G Riedel-Heller; Hans-Helmut König

doi:10.3389/fmed.2022.924818

Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts

Front Med (Lausanne). 2022 Sep 2:9:924818. doi: 10.3389/fmed.2022.924818. eCollection 2022.

Authors

Elżbieta W Buczak-Stec¹, André Hajek¹, Alexander Pabst², Christian Brettschneider¹, Hendrik van den Bussche³, Birgitt Wiese⁴, Siegfried Weyerer⁵, Jochen Werle⁵, Andreas Hoell⁵, Michael Pentzek⁶, Angela Fuchs⁶, Melanie Luppa², Margit Löbner², Janine Stein², Franziska Förster², Dagmar Weeg⁷, Edelgard Mösch⁷, Kathrin Heser⁸, Martin Scherer³, Wolfgang Maier^{8

9}, Matthias C Angermeyer¹⁰, Michael Wagner^{8

9}, Steffi G Riedel-Heller², Hans-Helmut König¹

Affiliations

¹ Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
³ Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴ Institute of General Practice, Hannover Medical School, Hannover, Germany.
⁵ Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
⁶ Institute of General Practice (ifam), Centre for Health and Society (chs), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
⁷ Department of Psychiatry, Technical University of Munich, Munich, Germany.
⁸ Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
⁹ German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
¹⁰ Center for Public Mental Health, Gösing am Wagram, Austria.

Abstract

Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany.

Methods: We used harmonized data from three large cohort studies from Germany ("Healthy Aging: Gender-specific trajectories into the latest life"; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels' services. Logistic regression models were used, adjusting for important sociodemographic variables.

Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels' services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24-1.76]; p < 0.001), whereas they had lower odds of using meals on wheels' services (OR = 0.64, 95% CI: [0.42-0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87-1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson's disease) and walking impairments.

Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels' services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care services may contribute to maintaining autonomy and independence in old age.

Keywords: gender differences; healthcare utilization; home care; home-based formal help; meals on wheels; outpatient nursing care; professional home care.

Copyright © 2022 Buczak-Stec, Hajek, Pabst, Brettschneider, van den Bussche, Wiese, Weyerer, Werle, Hoell, Pentzek, Fuchs, Luppa, Löbner, Stein, Förster, Weeg, Mösch, Heser, Scherer, Maier, Angermeyer, Wagner, Riedel-Heller and König.