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Patterns of Health and Social Services Utilization*

Published online by Cambridge University Press:  29 November 2010

François Béland
Affiliation:
Cité de la santé de Laval and Université de Montréal

Abstract

Utilization of an array of health and social services from formal and informal sources is studied here 1) to identify profiles of services utilization and 2) to predict the location of elderly in these profiles by a set of independent variables such as the sociodemographic characteristics of the elderly, their physical and mental health status and the density of their social support network. Two samples of non-institutionalized elderly living in two middle-sized towns were drawn from the universal old-age Canadian pension scheme. Their utilization of hospital, medical and pharmaceutical services was assessed, and their use of services for help with adivities of daily living was measured by a set of six indicators. A cluster analysis was run to identify profites of services utilization, and a discriminant analysis used the profiles as the criterion to be predicted by a set of variables. Five profiles of utilization were obtained; four of them identified elderly with very few experiences of services utilization and a fifth, a low number of elderly with utilization of all of the services listed in this study. Most of the elderly were users of a small subset of medical and social services. The location of elderly in the profiles was predicted by physical health status, coresidence and income. These results show that health and social services from both formal and informal sources are utilized by elderly. It is suggested that new types of formal agencies which consider the simultaneous delivery of social and health services will succeed inasmuch as they have the ability to interact with a system of informal care.

Résumé

L'utilisation des services de santé et des services sociaux a fait l'objet de nombreuses études au cours des dernières années. Mais peu de ces études ont tenté d'étudier l'utilisation conjointe d'une gamme de ces services. Cette étude vise à établir des profils d'utilisation de services de santé et de services sociaux offerts par des réseaux formels et informels d'aide. Par la suite, la capacité de caractéristiques socio-démographiques, de l'état de santé physique et mental et de la densité du réseau social de personnes âgées de deux échantillons urbains d'expliquer leur localisation dans les différents profils d'utilisation est examinée. Les deux échantillons de personnes âgées ont été tirés depuis le fichier de bénéficiaires du régime de pension universelle du gouvernement canadien. Leur utilisation de services hospitaliers et médicaux, leur consommation de médicaments et leur recours aux services d'aide aux activités de la vie quotidienne ont été mesurés. Les profils de services ont été identifiés à l'aide de l'analyse de regroupement, tandis que la capacité de classification des variables prédictrices de l'utilisation dans les profils a été évaluée par l'analyse discriminante. Cinq profils d'utilisation ont été identifiés par l'analyse discriminante. L'un d'eux regroupe les personnes avec une utilisation importante de tous les services tandis que les quatre autres profils regroupent des personnes qui utilisent peu de services de divers types. La localisation de personnes âgées dans les différents profils est prédite par la santé physique, la corésidence et le revenu. Les résultats de l'analyse tendent à démontrer que les services formels et informels de santé et de services sociaux sont utilisés par les personnes âgées selon des modalités treès différentes. Le succeès des organismes qui offrent une gamme de services sociaux et de santé dépend de leur capacité à tenir compte de cette double structure d'utilisation des services par les personnes âgées; soit une utilisation de services sociaux et de santé, provenant de sources formelles et informelles.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1989

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