Objectives: To investigate the use of home care services and the possible effects of reimbursement levels and other factors associated with the use of services. Methods: Six home care services providers, all under contractual agreement with the City of Taipei to provide services, were selected. Data (n=454), in the form of documents and clients records, was collected from the providers from January 2000 to March 2001. After the elimination of inappropriate data, the final number included for analysis was 440. Results: (1) About 63.4% of the cases used 16 hours of services a month. Among the 16-hour users, 13.8% were from low-income households. (2) Among the low-income users, 70% used more than 16 hours per month. Some (13.8%) used as many as 96 hours a month. For cases not in the low-income group, only 7.8% used more than 16 hours. (3) Logistic regression showed that, after controlling for other variables, the low-income (OR=50.8), severely disabled (OR=7.6), and the unmarried (OR=15.9) were more likely than their counterparts to use more than 16 hours of services per month. Furthermore, being younger, and having more family care resources were associated with using fewer hours. Conclusions: Level of reimbursement has significant impacts on the use of services, as indicated by the wide disparity in services hours used between low-income users and others. In planning for long-term care insurance, in order to avoid the skewing of needs for the use of services towards the low-income group, the design of reimbursement schemes should take into account both the ability to pay and also their level.
- Home care services
- Reimbursement level
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health