title: Gender disparities in German home-care arrangements.
abstract: An ageing population correlates with rising needs for long-term care (LTC). Support programmes should consider the specific needs of the various subgroups of care dependents and family caregivers. The objective of this study was to analyse the gender-specific disparities in home-care arrangements in Germany, and for this purpose, survey and insurance claims data were used. A survey of 2545 insured care recipients with high-level care needs was conducted in 2012 with the Barmer GEK, a major German statutory healthcare insurance. Insurance claims data were provided for a follow-up, focussing on the group aged 60 years and older. For statistical comparison, chi-squared test and t-tests were used, and a p-value < 0.05 was considered statistically significant. Most care recipients are female, and they are on average 2 years older than males. Men receive family care mostly from their wives, whereas widows frequently live alone and receive care from daughters, sons, other relatives, neighbours and friends, as well as from professional nursing services. Furthermore, women more often anticipate the need for (further) professional assistance and move in with a relative or to an assisted living facility or a nursing home in good time. The desired rate for relocation to a nursing home was higher than the anticipated, and during the 6-month follow-up, the actual rate of relocations was in between both. In summary, the caring situation of men and women is different. Care-receiving men are most often cared for by their wives. Widowed women need a social network and their children in order to remain in their own home. To provide better home-care arrangements for women in this situation, the family and social networks need a stronger focus in politics and research. To stabilise the home-care situation of men with high-level care needs, their wives need more support.
authors.affiliation: Graduate School Family Health in the Lifecourse, Faculty of Business Administration and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany.|Department of Nursing Science, Witten/Herdecke University, Witten, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Dorin
authors.affiliation: Bavarian Health and Food Safety Authority, Quality of Health Care, Health Economics, Health System Analysis (GE6), Nürnberg, Germany.
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Krupa
authors.affiliation: Graduate School Family Health in the Lifecourse, Faculty of Business Administration and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany.|Department of Nursing Science, Witten/Herdecke University, Witten, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Metzing
authors.affiliation: Graduate School Family Health in the Lifecourse, Faculty of Business Administration and Social Sciences, University of Applied Sciences Osnabrück, Osnabrück, Germany.|Department of Nursing Science, Witten/Herdecke University, Witten, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Büscher
mesh_terms: D005260:Female; D005858:Germany; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D012737:Sex Factors
keywords: gender disparities; home-care arrangements; insurance claims data; long-term care; utilisation