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KMID : 1170320240300010051
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Korean Journal of Health Economics and Policy
2024 Volume.30 No. 1 p.51 ~ p.78
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Association between spouse caregiver’s health and institutionalization decision of long-term care eligibles
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Yun Sung-Hun
Yoon Nan-He
Kim Hong-Soo
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Abstract
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Given that informal care provision is a substantial burden that limits labor force participation and worsens health, and that family caregiver's subjective perceptions of their care burden and health status may affect the institutionalization and use of other public care services of older adults with health and care needs, there is a need to further develop the current family caregiver support system. This study investigated the impact of spousal primary caregiver health status on institutionalization of older adults, focusing on the timing and targeting of family support services with the goal of delaying institutionalization of long-term care eligibles. After constructing a model with spousal primary caregiver health status variables as independent variables in addition to the set of independent variables based on Andersen's healthcare utilization model, the probability that the first service of a long-term care eligible is home-based care was estimated through a logistic regression model and the risk of institutionalization among those who chose home-based care as their first service was also estimated using a competing risk analysis. Furthermore, we conducted subgroup analyses by the health status of the long-term care eligibles. The results showed that spousal primary caregiver health was not statistically significantly associated with new long-term care eligibles choosing home-based care as their first service, but was statistically significantly associated with an increased risk of institutionalization among those who chose home-based care as their first service. This relationship was particularly strong for care of older adults with dementia and higher levels of severity. Based on our findings, we suggest prioritizing the timing and targeting of limited family caregiver support services and monitoring their effectiveness.
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KEYWORD
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long-term care insurance, spousal caregivers, care burden, aging in
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