Home health care for the elderly: associated factors and characteristics of access and health care.
OBJECTIVE
To assess factors associated with home health care for the elderly and its characteristics based on different care models, the Family Health Strategy and traditional primary care.


METHODS
A population-based cross-sectional study was conducted in a representative sample of 1,593 individuals aged >60 years living in the urban area of the city of Bagé, Southern Brazil, in 2008. A multistage sampling was carried out. Data was collected during individual interviews about access to services, providers' involvement, users' satisfaction and health status after care. Poisson regression model was used for estimating crude and adjusted prevalence ratios, their related 95% confidence intervals and p-values (Wald test).


RESULTS
Home health care was statistically associated with prior history of stroke, signs of dementia and disability in activities of daily living. The family was requested 75% of home care visits. Medical doctors provided most of the care in traditional primary care settings while nursing staff provided most care within the Family Health Strategy. Approximately 78% of the elderly received care within 24 hours after the request and 95% of them positively evaluated the care received. Two thirds of the elderly reported improved health status.


CONCLUSIONS
The variables associated with home health care were consistent with fragility indicators included in the Brazilian National Health Policy for the Elderly, reinforcing the role of this strategy for promoting equitable health care to elderly population. Users' satisfaction and the positive impact on their health status confirm home as a setting for providing care.
Thumé
Elaine
E
Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, RS, Brasil. elainethume@gmail.com
Facchini
Luiz Augusto
LA
Tomasi
Elaine
E
Vieira
Lúcia Azambuja Saraiva
LA
D000368:Aged; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006291:Health Policy; D006299:Health Services for the Aged / Q000592:standards* / Q000706:statistics & numerical data; D006699:Home Care Services / Q000592:standards* / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017064:Process Assessment, Health Care; D012959:Socioeconomic Factors