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 language | English (US) |
|---|---|
| Pages (from-to) | 99-121 |
| Number of pages | 23 |
| Journal | AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV |
| Volume | 13 |
| Issue number | 1 |
| DOIs | |
| State | Published - 2001 |
| Externally published | Yes |
Fingerprint
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 journal › Article
}
TY - JOUR
T1 - Use of unpaid and paid home care services among people with HIV infection in the USA
AU - London, Andrew 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.
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.
UR - http://www.scopus.com/inward/record.url?scp=0035142727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035142727&partnerID=8YFLogxK
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 -