title: Formal home help services and institutionalization.
abstract: The effect of home help services has been inconsistent. Raising the hypothesis that receiving small amounts of home help may postpone or prevent institutionalization, the aim of the present study is to analyze how light and heavy use of home help services was related to the risk for institutionalization. The study was a secondary analysis of a Danish intervention study on preventive home visits in 34 municipalities from 1999 to 2003, including 2642 home-dwelling older people who were nondisabled and did not receive public home help services at baseline in 1999 and who lived at home 18 months after baseline. Cox regression analysis showed that those who received home help services during the first 18 months after baseline were at higher risk of being institutionalized during the subsequent three years than those who did not receive such services. However, receiving home help for less than 1h per week during the first 18 months after baseline was not associated with an increased risk of institutionalization during the study period among those with physical or mental decline. Receiving public home help services was a strong indicator for institutionalization in Denmark. Receiving small amounts of home help and experiencing physical or mental decline was not associated with higher hazard for institutionalization compared with those who received no help.
authors.affiliation: Section of Social Medicine, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, DK-1014, Copenhagen, Denmark. yuya@sund.ku.dk
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yamada
authors.forename: Volkert
authors.initials: V
authors.lastname: Siersma
authors.forename: Kirsten
authors.initials: K
authors.lastname: Avlund
authors.forename: Mikkel
authors.initials: M
authors.lastname: Vass
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006796:Household Work / Q000706:statistics & numerical data; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D007326:Institutionalization / Q000706:statistics & numerical data*; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires