Is there equity in initial access to formal dementia care in Europe? The Andersen Model applied to the Actifcare cohort
Open accessAbstract
OBJECTIVES: In the current study, the Anderson model is used to determine equitable access to dementia care in Europe. Predisposing, enabling, and need variables were investigated to find out whether there is equitable access to dementia-specific formal care services. Results can identify which specific factors should be a target to improve access. METHODS: A total of 451 People with middle-stage dementia and their informal carers from eight European countries were included. At baseline, there was no use of formal care yet, but people were expected to start using formal care within the next year. Logistic regressions were carried out with one of four clusters of service use as dependent variables (home social care, home personal care, day care, admission). The independent variables (predisposing, enabling, and need variables) were added to the regression in blocks. RESULTS: The most significant predictors for the different care clusters are disease severity, a higher sum of (un)met needs, hours spent on informal care, living alone, age, region of residence, and gender. CONCLUSION: The Andersen model provided for this cohort the insight that (besides need factors) the predisposing variables region of residence, gender, and age do play a role in finding access to care. In addition, it showed us that the numbers of hours spent on informal care, living alone, needs, and disease severity are also important predictors within the model's framework. Health care professionals should pay attention to these predisposing factors to ensure that they do not become barriers for those in need for care.
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Such variations can exist due to the social gradient in wider determinants of health, differences in local funding and service equity, the make-up of local healthcare systems and regional differences in population composition.
“Such variations can exist due to the social gradient in wider determinants of health, differences in local funding and service equity, the make-up of local healthcare systems and regional differences in population composition [34,35,36,37].”
From The Impact of demographic, socio-economic and geographic factors on mortality risk among people living with dementia in England (2002–2016) (2021) · cites this paper as [36]
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- Authors
- Kerpershoek, L., de Vugt, M., Wolfs, C., Orrell, M., Woods, B., Jelley, H., Meyer, G., Bieber, A., Stephan, A., Selbæk, G., Michelet, M., Wimo, A., Handels, R., Irving, K., Hopper, L., Gonçalves‐Pereira, M., Balsinha, C., Zanetti, O., Portolani, D., Verhey, F., & the Actifcare Consortium
- Affiliations
- Maastricht University (NL)
- Maastricht University Alzheimer Centrum Limburg NL The Netherlands
- University of Nottingham (GB)
- Bangor University (GB)
- Martin Luther University Halle-Wittenberg (DE)
- Oslo University Hospital (NO)
- Karolinska Institutet (SE)
- Dublin City University (IE)
- Universidade Nova de Lisboa (PT)
- Centro San Giovanni di Dio Fatebenefratelli (IT)
- IRCSS Istituto Centro S. Giovanni di Dio Fatebenefratelli Brescia IT
- ORCID
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2019-11-06
- Volume
- 35
- Issue
- 1
- Pages
- 45-52
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- PMC
- PMC6916585
- OpenAlex
- W2982108208
- Cited by
- 26
- References
- 35
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 1 · 2022: 6 · 2021: 7 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Dublin City University Open Access Institutional Repository (Dublin City University) (submittedVersion, other-oa)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- EU Joint Programme – Neurodegenerative Disease Research (733051001)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- dementia care, health care access, health equity, Andersen Behavioral Model, informal caregivers, home care, daycare centers, institutionalization, unmet needs, disease severity, living alone, gender differences, regional disparities
- MeSH terms
- Health Equity, Aged, Aged, 80 and over, Dementia, Europe, Female, Health Services Accessibility, Humans, Male, Middle Aged, Models, Theoretical, Cohort Studies
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