Home health and informal care utilization and costs over time in Alzheimer's disease

Carolyn Zhu, Rebecca Torgan, Nikolaos Scarmeas, Marilyn Albert, Jason Brandt, Deborah Blacker, Mary Sano, Yaakov Stern

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To (1) compare home health and informal (unpaid) services utilization among patients with Alzheimer's disease (AD), (2) examine longitudinal changes in services use, and (3) estimate possible interdependence of home health and informal care utilization. Methods: The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed annually for up to 7 years in three university-based AD centers. Bivariate probit models estimated the effects of patient characteristics on home health and informal care utilization. Results: A large majority of the patients (80.6%) received informal care with a smaller proportion (18.6%) receiving home health services. Home health services utilization increased from 9.9% at baseline to 34.5% in year 4. Among users, number of days that services were provided in three-month recall increased from 21.9 to 56 days over time. Home health services utilization was significantly associated with function, depressive symptoms, being female, and not living with a spouse. Informal care utilization was significantly associated with cognition, function, comorbidities, and living with a spouse or child. Conclusions: Home health and informal care utilization relate differently to patient characteristics. Utilization of home health care or informal care was not influenced by utilization of the other.

Original languageEnglish (US)
Pages (from-to)1-20
Number of pages20
JournalHome health care services quarterly
Volume27
Issue number1
DOIs
StatePublished - 2008

Keywords

  • Cost
  • Dementia
  • Home health service
  • Informal care
  • Longitudinal study

ASJC Scopus subject areas

  • Health Policy
  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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