| アブストラクト | BACKGROUND: The daily management of long-term conditions falls primarily on individuals and informal carers, but the impact of household context on health and social care activity among people with multiple long-term conditions (MLTCs) is understudied. AIM: To test whether co-residence with a person with MLTCs (compared with a co-resident without MLTCs) is associated with utilisation and cost of primary, community, secondary health care, and formal social care. DESIGN & SETTING: Linked data from health providers and local government in Barking and Dagenham for a retrospective cohort of people aged >/=50 years in two-person households in 2016-2018. METHOD: Two-part regression models were applied to estimate annualised use and cost of hospital, primary, community, mental health, and social care by MLTC status of individuals and co-residents, adjusted for age, sex, and deprivation. Applicability at the national level was tested using the Clinical Practice Research Datalink (CPRD). RESULTS: Forty-eight per cent of people with MLTCs in two-person households were co-resident with another person with MLTCs. They were 1.14 (95% confidence interval [CI] = 1.00 to 1.30) times as likely to have community care activity and 1.24 (95% CI = 0.99 to 1.54) times as likely to have mental health care activity compared with those co-resident with a healthy person. They had more primary care visits (8.5 [95% CI = 8.2 to 8.8] versus 7.9 [95% CI = 7.7 to 8.2]) and higher primary care costs. Outpatient care and elective admissions did not differ. Findings in national data were similar. CONCLUSION: Care utilisation for people with MLTCs varies by household context. There may be potential for connecting health and community service input across household members. |
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| ジャーナル名 | BJGP open |
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| 投稿日 | 2020/11/26 |
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| 投稿者 | Stafford, Mai; Deeny, Sarah R; Dreyer, Kathryn; Shand, Jenny |
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| 組織名 | The Health Foundation, London, UK mai.stafford@health.org.uk.;The Health Foundation, London, UK.;UCLPartners, London, UK.;Institute of Epidemiology & Health Care, University College London, London, UK.;Care City, Barking, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33234513/ |
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