Predicting the utilization of home care and personal care homes by community-dwelling older Manitobans

Understanding the reasons why older adults use home care and personal care homes (PCHs) is necessary to manage the care and costs of these health care services. The present research has used a representative sample of older adults from Manitoba, Canada, to compare how prevalence and incidence risk factors predict the use of home care and PCHs. The Andersen-Newman Model of Health Care Utilization was incorporated into analytic strategies, and was used to help interpret study results.; Study participants completed the 1983 and 1990 Aging in Manitoba (AIM) interviews, and participants' responses to these questions were used as potential risk factors. These AIM data were linked to the government of Manitoba administrative health records that described participants' use of home care and PCHs. Prevalence and incidence risk factor data were used to develop four statistical models to determine participants' risk of using these health care services.; This research has helped to define users of home care and PCHs. People with functional limitations were more likely to use PCHs, and those with chronic health conditions and physical impairments were more likely to use home care. Participant age and sex, and indicators of social supports indirectly influenced the use of these health care services. Males and younger people with a health limitation were more likely to use home care, while females and people age 85 years and older were more likely to use PCHs. Individuals with fewer social supports were more likely to use home care and PCHs.; Study results were more strongly demonstrated with incidence data, and the sequence of events leading to the use of home care and PCHs was also better defined with these time sensitive measures. The Andersen-Newman model helped to understand how different risk factors influenced the use of home care and PCHs. However, as has been noted by other researchers, it remains difficult to accurately predict the use of these health care services.; Policy recommendations from this work include identifying people who may be more likely to use home care and PCHs, and developing strategies to offset the use of these services. Recommendations for future research include collecting incidence data with shorter time intervals, and assessing complex statistical interaction terms to better understand how some variables may effect the use of home care or PCHs.