A multi-level perspective on perceived unmet needs for home support in home-dwelling older adults in the Swiss context: a secondary data analysis of a population study

Maria Jose Mendieta, Sabina M. De Geest, Geert Goderis, Olivia Yip, Mieke Deschodt, Suzanne Dhaini, Inspire Consortium
Unmet needs for home support occur when any support services perceived by older people as needed are not being received. Not meeting these needs can negatively impact older adults' quality of life, and increase health care utilization, hospitalizations, institutionalizations, or death. To date there is no consensus in how to define and assess these unmet needs. In parallel, previous research of factors associated with unmet needs for home support has mostly focused on factors at the micro
more » ... Thus, this paper aims to identify the prevalence of unmet needs for home support among a home-dwelling older population and the factors at the macro, meso and micro levels contributing to them. Methods Using an ecological approach we identified multi-level factors associated with the presence of unmet needs for home support among the home-dwelling older population (aged 75+) in Switzerland. This is a secondary cross-sectional analysis of the INSPIRE Population Survey of home-dwelling older adults (n = 8,508) living in Basel-Landschaft in Switzerland, conducted as part of the TRANS-SENIOR Project. Prevalence of perceived unmet needs for home support was self-reported, using a dichotomized question. Multiple logistic regression analyses were performed to investigate the associations of factors at each level with unmet needs for home support. Results 4.3% of participants reported unmet needs for home support, with a median age of 81 years. 45.1% had private health insurance and 6.3% needed additional government support. Being a recipient of other type of government support (OR = 1.65; 95% CI = 1.17-2.29) (macro-); the use of transportation services (OR = 1.74; 95% CI = 1.15-2.57) (meso-); and feeling depressed (OR = 1.40; 95% CI = 1.06-1.85) or abandoned (OR = 2.60; 95% CI = 1.96-3.43) (micro-) increased odds of having perceived unmet needs for home support. Having a private health insurance (macro-) (OR = 0.63; 95% CI = 0.49-0.80), speaking Swiss-German (OR = 0.44; 95% CI = 0.24-0.88) or German (OR = 0.47; 95% CI = 0.24-0.98), having a high level of education [primary (OR = 0.48; 95% CI = 0.24-1.02); secondary (OR = 0.49; 95% CI = 0.25-1.03); tertiary (OR = 0.38; 95% CI = 0.19-0.82); other (OR = 0.31 (0.12-0.75)], having a high
doi:10.5451/unibas-ep90198 fatcat:t3qvyd6yizemlizykbcki5sppe