Use of unpaid and paid home care services among people with HIV infection in the USA

Andrew S London, J. A. Fleishman, D. P. Goldman, D. F. McCaffrey, S. A. Bozzette, M. F. Shapiro, A. A. Leibowitz

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

This paper examines utilization of paid and unpaid home health care using data from a nationally representative sample of HIV-positive persons receiving medical care in early 1996 (N = 2,864). Overall, 21.0% used any home care, 12.2% used paid care and 13.6% used unpaid care. Most (70.0%) users of home care received care from only one type of provider. Substantially more hours of unpaid than paid care were used. We also found evidence of a strong association between type of service used and type of care provider: 62.4% of persons who used nursing services only received paid care only; conversely, 55.5% of persons who used personal care services only received care only from unpaid caregivers. Use of home care overall was concentrated among persons with AIDS: 39.5% of persons with AIDS received any home health care, compared to 9.5% of those at earlier disease stages. In addition to having an AIDS diagnosis, logistic regression analyses indicated that other need variables significantly increased utilization; a higher number of HIV-related symptoms, lower physical functioning, less energy, a diagnosis of CMV and a recent hospitalization each independently increased the odds of overall home care utilization. Sociodemographic variables had generally weak relationships with overall home care utilization. Among users of home care, non-need variables had more influence on use of paid than unpaid care. Both paid and unpaid home health care is a key component of community-based systems of care for people with HIV infection. The results presented in this paper are the first nationally representative estimates of home care utilization by persons with HIV/AIDS and are discussed with reference to policy and future research.

Original languageEnglish (US)
Pages (from-to)99-121
Number of pages23
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume13
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Home Care Services
home care
HIV Infections
utilization
human being
Acquired Immunodeficiency Syndrome
AIDS
HIV
health care
Delivery of Health Care
nursing services
Nursing Services
hospitalization
medical care
Caregivers
caregiver
Hospitalization
Logistic Models
logistics
Regression Analysis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)
  • Social Sciences (miscellaneous)

Cite this

Use of unpaid and paid home care services among people with HIV infection in the USA. / London, Andrew S; Fleishman, J. A.; Goldman, D. P.; McCaffrey, D. F.; Bozzette, S. A.; Shapiro, M. F.; Leibowitz, A. A.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Vol. 13, No. 1, 2001, p. 99-121.

Research output: Contribution to journalArticle

London, Andrew S ; Fleishman, J. A. ; Goldman, D. P. ; McCaffrey, D. F. ; Bozzette, S. A. ; Shapiro, M. F. ; Leibowitz, A. A. / Use of unpaid and paid home care services among people with HIV infection in the USA. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2001 ; Vol. 13, No. 1. pp. 99-121.
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