TY - JOUR
T1 - Use of unpaid and paid home care services among people with HIV infection in the USA
AU - London, A. S.
AU - Fleishman, J. A.
AU - Goldman, D. P.
AU - McCaffrey, D. F.
AU - Bozzette, S. A.
AU - Shapiro, M. F.
AU - Leibowitz, A. A.
N1 - Funding Information:
An eairrevelrsion of this paper was presentdeat the 1998 annual meetngiof the Ameriacn Sociologiacl Associant. TieoHIhVCost and Sercves UitiizlnaStudty iis beoing conductde under co-operaetagivmernet U-e0S1708 H(M8.FS5h., PIa; SpA..Birzooe,Czot-tI)Pe between RAND and the Agency for Healtarhe Rescearch and Quality. Substantial addiotnali funding for this co-operative aeemegnrt was provided by the Health Resources and Secres vi Administration, the National Institute of Mental Health, the National Institute on Drug Abuse and the National Institutes of Heath OflŽ ce of Researh con Minoty rHealtih through the National Institute of Dental Reseach.rAdditialosuppornt was povdrediby the Robert Wood Johnson Foundation, Merck and Company, GlaWellcoxome,-Incorporated, the Naonatl iIsnittteuonAging and the OfŽ ce of the Assistant Secretary for Paninlng ad n Evaluation in the US Department of Health and Human Serivesc. The viwes expressed in this paper are those of the authors. No ofŽ cial endorsement by the Department of Health and Human Services or by the Agency for Healthcare Reseachr and Quaiytlshould be inferred.
Copyright:
Copyright 2012 Elsevier B.V., All rights reserved.
PY - 2001
Y1 - 2001
N2 - 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.
AB - 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.
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U2 - 10.1080/09540120020018215
DO - 10.1080/09540120020018215
M3 - Article
C2 - 11177468
AN - SCOPUS:0035142727
VL - 13
SP - 99
EP - 121
JO - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
JF - AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
SN - 0954-0121
IS - 1
ER -