Background: Population ageing has significant effects on societies. The organization of care for dependent old people is one of the key issues for ageing societies. The majority of care for homebound dependent old people in Slovenia is still performed by informal carers, even though the use of formal services has been increasing over the last 20 years. The proportion and characteristics of people with unmet needs are important for the development of long term care social policy.
Method: The SHARE (Survey of Health, Ageing and Retirement in Europe) survey was used to assess the determinants of care arrangements and of unmet needs of the aging population in Slovenia. Multinomial regression analysis was used to evaluate individual and contextual determinants of care arrangements and unmet needs.
Results: The proportion of older people with unmet needs is 4%. As expected, "needs" (Functional impairment OR=4.89, P=0.000, Depression OR=2.59, P=0.001) were the most important determinant, followed by the predisposing factor "age" (age OR 1.15, P=0.000) and two enabling factors, namely:"community setting and "availability of informal care within household" (Urban areas OR=.47, P=0.021; Household size 3+ OR=2.11, P=0.030).
Conclusion: This study showed that there are a proportion of older people in Slovenia with severe needs for care, which are being unmet. As shown by the importance of enabling factors, social policy should encourage the development of formal services in rural areas and elaborate policy measures for informal carers.
Izhodišče: Staranje prebivalstva je še posebej pomembno v razvitih družbah. Organizacija oskrbe za stare in odvisne ljudi je ena od ključnih tem, s katerimi se te družbe ukvarjajo. Večino oskrbe starih ljudi v domačem okolju opravijo neformalni oskrbovalci, čeprav so se v zadnjih dvajsetih letih v Sloveniji razvile tudi formalne storitve. Delež in značilnosti ljudi z nezadovoljenimi potrebami po oskrbi sta pomembni informaciji za načrtovalce dolgotrajne oskrbe.
Metoda: Za oceno deleža starih ljudi z nezadovoljenimi potrebami po oskrbi smo uporabili podatke raziskave SHARE (Survey of Health, Ageing and Retirement in Europe). Za oceno vpliva individualnih in posredujočih dejavnikov na nezadovoljene potrebe po oskrbi smo uporabili multinominalno regresijsko analizo.
Rezultati: V Sloveniji 4% starih ljudi nima zadovoljenih potreb po oskrbi. Kot pričakovano, je najpomembnejša determinanta potreba po oskrbi (funkcionalne omejitve OR=4,89, P=0,000, depresije OR=2,59, P=0,001). Med individualnimi determinantami ima značilen vpliv starost (starost OR 1,15, P=0,000), med posredujočimi pa tip bivalnega okolja in razpoložljivost neformalnih oskrbovalcev (urbano okolje OR=,47, P=0,021; velikost gospodinjstva 3+ OR=2,11, P=0,030).
Zaključek: V Sloveniji obstajajo stari ljudje z nezadovoljenimi potrebami po oskrbi. Kot kaže multinominalna regresija, bi načrtovalci dolgotrajne oskrbe morali več pozornosti nameniti razvoju storitev v ruralnem okolju in bolj podpirati neformalne oskrbovalce.
Keywords: Andersen’s behavioural model; SHARE; formal and informal care; multinomial regression analysis; older people; surveys; unmet needs.