[Health problems also explain social services use in home care].
OBJECTIVE
To identify which social and health variables are associated with receiving social services in patients included in home care programmes with the implementation of the Dependence Law.


METHODS
Cross-sectional study.


METHODS
72 primary health care teams in Catalonia.


METHODS
Patients over 64 years old with chronic diseases in home care programmes in Catalonia.


METHODS
Health status variables: Charlson, Barthel, Pfeiffer, Braden and Gijon, data from their carer (Zarit), self perception of health (SF-12), health professional visits, as well as: emergency visits, temporary admissions, and final results such as death or definitive admission in a nursing home or a hospital.


RESULTS
A total of 1068 patients were included, 46.8% of the patients received some kind of social service, public or private. We observed that the variables related to receive some kind of social services are: high dependence (Barthel test), pressure sores and home care rehabilitation. Barthel test is highly associated with having social problems (Gijon test), living without an informal carer, more than 2 GP visits and having additional private health care.


CONCLUSIONS
To be more fair, the evaluation of the provisions of the Dependence Law should also consider the health status of the patient. With the implementation of this law we can observe difficulties in access to social services for middle class patients. These patients do not have access to public social assistance and cannot pay for a private one. Social services are still an alternative to family care.
Gené Badia
Joan
J
CAPSE Consorci d'Atenció Primària de Salut de l'Eixample, Barcelona, España. jgene@clinic.ub.es
Contel Segura
Joan Carles
JC
Hidalgo García
Antonio
A
Borràs Santos
Alícia
A
Porta Borges
Montserrat
M
Oliver Olius
Anna
A
Saus Arus
Montse
M
Ascaso Terren
Carlos
C
Piñeiro González
Martiño
M
Cegri Lombardo
Francisco
F
Limón Ramírez
Esther
E
Aranzana Martínez
Antonio
A
Heras Tebar
Antonio
A
Noguera Rodríguez
Ramón
R
Pedret Llaberia
Roser
R
Borrell Muñoz
Manuel
M
Camprubí Casellas
M Dolors
MD
Ortiz Molina
Jacinto
J
Martín Royo
Jaume
J
Gonzalez Martinez
Susana
S
D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012947:Social Work / Q000706:statistics & numerical data*; D013030:Spain