How do socioeconomic circumstances influence older adults’ use of social care and health services? Findings from the Newcastle 85+ study

Conference:

SAPC ASM 2018 - London

Talk Code:

5A.2

Presenter:

Gemma Spiers

Co-authors:

A. Kingston, F. Matthews, S. Moffatt, B. Hanratty, and the Newcastle 85+ Study

Author institutions:

Institute for Health & Society, Newcastle University

Problem

Evidence shows that poor access to social care is associated with increased use of healthcare by older adults. We also know that social care utilisation is influenced by socioeconomic circumstances, because it is often subject to user charges. A better understanding is needed of the relationship between socioeconomic circumstances and the use of health and social services, to ensure the principle of equity is being upheld in older adult care. The aim of this research is to explore the relationship between these three factors using data from the Newcastle 85+ study.

Approach

The Newcastle 85+ study is a prospective cohort study based in North East England. People born in 1921 who were registered with a participating general practice in Newcastle upon Tyne or North Tyneside Primary Care Trusts were invited to participate. Data collection started in 2006 when participants were 85 years of age. Data were collected face to face and via GP record review. Information on use of social care (homecare, residential care and nursing homes), general practice (GP contacts) and hospital services (inpatient admission, length of stay, outpatient visit), measures of socio-economic circumstances (housing tenure, Index of Multiple Deprivation, receipt of welfare benefits, other income sources), health (presence of a longstanding illness or disability, number of diseases), dependency and demographic characteristics were collected. Follow up was at four further time points up to the age of 95 years. Cross sectional and longitudinal analyses were used to model the relationships between socio-economic circumstance, use of social services and healthcare, adjusting for need and other relevant factors.

Findings

At age 85 years (phase 1, n=849), a majority of participants (80%) had a longstanding illness or disability. Thirteen percent lived in sheltered accommodation and 10% lived in a care or nursing home. Of those living in the community (n=757), 20% received some form of home care. Healthcare utilisation was common: 94% had contacted their GP in the past year, 32% attended an outpatient clinic and 22% had an inpatient admission. Thirty-four percent of participants were social renters, 63% owned their homes and similar proportions lived in the least (20%) and most (19%) deprived areas designated by quintiles of the Index of Multiple Deprivation. Almost half of participants (49%) were receiving state welfare benefits; 14% had only the state pension (with or without welfare benefits) as a source of income. Early modelling results will be presented.

Consequences

Outputs from this study will show how socioeconomic circumstances influence the relationship between older adults’ use of social care and health services. This is a neglected topic in research, with important implications for health, social care and ageing policy.

Submitted by:

Gemma Spiers

Funding acknowledgement:

This work was funded as part of a PhD studentship by the National Institute of Health Research School for Primary Care Research. The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the Department of Health. The Newcastle 85+ study has been funded by the Medical Research Council, Biotechnology and Biological Sciences Research Council, the Dunhill Medical Trust and the National Institute of Health Research School for Primary Care. Parts of the work have also been funded by the British Heart Foundation, Unilever Corporate Research, Newcastle University, Newcastle Healthcare Charity and the North of England Commissioning Support Unit.