What Drove Clients' Decisions to Pause Personal Homecare Services Before and During the Pandemic?

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Health Services Insights Pub Date : 2025-04-29 eCollection Date: 2025-01-01 DOI:10.1177/11786329251335877
Prakathesh Rabeenthira, Katherine A P Zagrodney, Emily C King, Kathryn A Nichol, Sandra M McKay
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引用次数: 0

Abstract

Background: With an increasing reliance on homecare and a scarcity of providers, there is potential to gain insight from existing administrative data to optimize planning and care delivery. To enable more accurate predictions of service use, it is important to understand the degree to which various factors influence clients' difficult decisions to temporarily pause their receipt of necessary homecare services.

Objectives: We utilized a large, longitudinal, administrative dataset to examine the relative effects of client-level factors on the outcomes of (1) placing a hold on homecare services and (2) the length of a homecare service hold, through stratified regression analyses separated by pre-, early-, and mid-pandemic periods.

Design: Descriptive summaries of the samples consisted of graphical representation and frequencies (proportions) or means. The relationship between client sociodemographic and homecare utilization factors on the service hold initiation and length were evaluated using mixed-effects logistic and linear regression, respectively, stratified by pre-, early-, and mid-pandemic periods. Odds ratios (OR) for hold initiation and exponentiated estimates for hold length were calculated with corresponding 95% confidence intervals.

Results: Findings provide a better understanding of the decisions made by a large sample of homecare clients to pause their homecare services in pre-, early-, and mid-pandemic scenarios. Frequency and length of service holds more than doubled in the early-pandemic period; although hold frequencies then returned to pre-pandemic rates, hold durations remained slightly longer. There were notable differences over time, but generally, clients with higher care needs had a reduced likelihood of placing a hold on homecare services. Shorter homecare tenure and previously cancelling individual homecare visits were also good indicators of future service decisions.

Conclusion: Findings are relevant for organizations providing homecare services, policymakers, and those interested in predicting homecare utilization for resource allocation planning with the goal of optimal care delivery.

是什么促使客户决定在大流行之前和期间暂停个人家庭护理服务?
背景:随着对家庭护理的日益依赖和提供者的稀缺,有可能从现有的行政数据中获得洞察力,以优化规划和护理交付。为了更准确地预测服务的使用情况,重要的是要了解各种因素在多大程度上影响客户暂时停止接受必要的家庭护理服务的艰难决定。目的:我们利用一个大型的纵向管理数据集,通过分层回归分析,按大流行前、早期和中期分开,研究客户层面因素对(1)暂停家庭护理服务和(2)暂停家庭护理服务的时间长短的相对影响。设计:样本的描述性摘要由图形表示和频率(比例)或平均值组成。使用混合效应逻辑回归和线性回归分别评估了客户社会人口统计学和家庭护理利用因素对服务等待开始和时间长短的影响,并按大流行前、早期和中期进行分层。用相应的95%置信区间计算滞留起始的优势比(OR)和滞留长度的指数估计。结果:研究结果更好地理解了大样本家庭护理客户在大流行前、早期和中期暂停家庭护理服务的决定。在大流行初期,服务的频率和时间增加了一倍以上;尽管持有的频率随后恢复到大流行前的水平,但持有的持续时间仍稍长。随着时间的推移,有显著的差异,但一般来说,有更高护理需求的客户搁置家庭护理服务的可能性降低。较短的家庭护理任期和以前取消个人家庭护理访问也是未来服务决策的良好指标。结论:研究结果对提供家庭护理服务的组织、政策制定者和那些对预测家庭护理利用情况以实现最佳护理目标的资源分配计划感兴趣的人具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health Services Insights
Health Services Insights HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.60
自引率
0.00%
发文量
47
审稿时长
8 weeks
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