Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark.
BACKGROUND
Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association.


METHODS
The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender.


RESULTS
Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0)). However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals.


CONCLUSIONS
High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.
Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. yukari.yamada@upol.cz
Yukari
Y
Yamada
Anette
A
Ekmann
Charlotte Juul
CJ
Nilsson
Mikkel
M
Vass
Kirsten
K
Avlund
D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000191:economics; D054625:Healthcare Disparities / Q000191:economics; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000193:education / Q000592:standards; D015995:Prevalence; D011314:Preventive Health Services / Q000191:economics / Q000379:methods*; D015397:Program Evaluation; D012111:Residence Characteristics; D017678:Sex Distribution; D012923:Social Class; D011795:Surveys and Questionnaires