title: Use of adult day care centers: do they offset utilization of health care services?
abstract: OBJECTIVE
  Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital admissions, length of hospitalizations, and visits to emergency departments).
  
  
  METHODS
  A case-control study was used with a sample of 800 respondents, of whom 400 were users of 13 day care centers in the southern region of Israel and 400 were nonusers, matched by age, gender, and active family physician. Data collection included face-to-face interviews using a structured questionnaire. Data on health care service utilization were drawn from the central computerized data of one of the health care organizations in Israel.
  
  
  RESULTS
  Although users of ADCC significantly differed from nonusers in socioeconomic characteristics, they did not significantly differ from nonusers in the magnitude of health care services' utilization. Utilization of health care services was rather connected with morbidity rather than with use of ADCC. Therefore, no offset effect was found.
  
  
  CONCLUSIONS
  The current form of ADCC in Israel focuses mainly on meeting social needs of the participants and therefore do not meet the their actual health needs. Therefore, inclusion of health services within ADCC may have an offset effect, but this necessitates further examination.
authors.affiliation: Department of Sociology of Health and Gerontology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. iecovich@bgu.ac.il
authors.forename: Esther
authors.initials: E
authors.lastname: Iecovich
authors.forename: Aya
authors.initials: A
authors.lastname: Biderman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003631:Day Care, Medical / Q000706:statistics & numerical data*; D006233:Persons with Disabilities; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007407:Interviews as Topic; D007557:Israel; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires