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Investigating factors influencing quality-of-life effects of home care services in Austria, England and Finland: a comparative analysis
- Authors:
- TRUKESCHITZ Birgit, et al
- Journal article citation:
- Journal of European Social Policy, 31(2), 2021, pp.192-208.
- Publisher:
- Sage
European countries have developed a range of long-term care (LTC) policy responses to support the increasing share of older people. However, little is known about the effectiveness of LTC services and benefits, particularly their impact on older peoples’ quality of life (QoL). This paper investigates the role of personal, care service and environmental characteristics on the effects of home care services on QoL across England, Finland and Austria. This study used data from surveys conducted in England, Finland and Austria. In total, 811 older adults were included in the analysis. OLS regression including main effects and country-specific interactions was used to explore variation in gains in long-term care service-related quality-of-life (LTC-QoL). Explanatory variables were derived from the production of welfare framework and comprised home care service user socio-demographics, needs indicators, social support and environmental variables and characteristics of home care service provision. In all three countries, LTC-QoL gains increased with needs, indicating that home care services perform well, with additional gains declining the higher the needs. Also, better process quality contributed to LTC-QoL improvements in all three countries. In addition, the availability of informal care, social contact, financial household situation and living alone, were associated with changes in LTC-QoL only in one or two of the countries. Home care services increased service users’ QoL in all three European countries. The increase in QoL, however, varied across the countries. The results also provide insights into the benefits and limits of home care service provision and areas for future improvements. (Edited publisher abstract)
Yet another black box: brokering agencies in the evolving market for live-in migrant care work in Austria and Germany
- Authors:
- LEIBER Simone, et al
- Journal article citation:
- International Journal of Care and Caring, 5(2), 2021, pp.187-208.
- Publisher:
- Policy Press
This article analyses the new market for live-in migrant care work in Germany and Austria, focusing on brokering agencies as intermediary actors. The analysis presents unique data on the field by combining an online survey of brokerage agencies with semi-structured qualitative expert interviews. We show that the sector is growing swiftly and dominated by small businesses in both countries but is quite diverse in terms of regional presence, corporate strategies and the relationship with established welfare organisations. Despite different legal settings, malpractices at the household level seem to be constitutive of the brokerage market in Germany as well as in Austria. (Edited publisher abstract)
Under reconstruction: the impact of COVID-19 policies on the lives and support networks of older people living alone
- Authors:
- PFABIGAN Johanna, et al
- Journal article citation:
- International Journal of Care and Caring, 6(1-2), 2022, pp.211-228.
- Publisher:
- Policy Press
In the spring of 2020, the Austrian government introduced COVID-19 containment policies that had various impacts on older people living alone and their care arrangements. Seven qualitative telephone interviews with older people living alone were conducted to explore how they were affected by these policies. The findings show that the management of everyday life and support was challenging for older people living alone, even though they did not perceive the pandemic as a threat. To better address the needs of older people living alone, it would be important to actively negotiate single measures in the area of conflict between protection, safety and assurance of autonomy. (Edited publisher abstract)
Home care nursing for persons with dementia from a family caregivers' point of view: predictors of utilisation in a rural setting in Austria
- Authors:
- KRUTTER Simon, et al
- Journal article citation:
- Health and Social Care in the Community, 30(1), 2022, pp.389-399.
- Publisher:
- Wiley
The service utilisation of persons with dementia (PwD) and their caregivers is subject to lively debate. The reasons for non-utilisation are manifold and heterogeneous. Conceptual models and explanatory frameworks may help identify predictors of the usage of health services. Literature examining the utilisation of home care services for PwD is scarce. This study explored predictors of home care nursing utilisation of PwD and their informal caregivers in a rural setting, according to the Andersen Behavioural Model of Health Care Use. A mixed-methods study was conducted in a rural area of Austria. In using non-random multistage sampling, anonymous questionnaires were distributed to collect data on family caregivers of PwD. Data were analysed using sequential binary logistic regression to characterise home care service users. To reflect the complexity of the Andersen model, a regression tree model was used. In total, 107 family caregivers completed the survey. Predisposing factors for home care nursing utilisation were higher age of the caregiver, female gender of PwD and kinship of the PwD and caregiver. Disruptive behaviour and independence in activities of daily living of PwD were associated with need factors for service use. According to the Andersen model, the predisposing and need factors contributed most to the explanation of home care nursing utilisation. The enabling factors employment, education and income tend to predict service use. Our findings indicate that higher age of the family caregiver and female gender of PwD are the main predictors for utilisation of home care nursing in a rural setting. To improve utilisation, the advantages of professional care services should be promoted, and the awareness about the variety of services available should be increased. To ensure a better understanding of the barriers to accessing home care, PwD should more often be included in healthcare service research. (Edited publisher abstract)
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Livindhome: living independently at home: reforms in home care in 9 European countries
- Authors:
- ROSTGAARD Tina, et al
- Publisher:
- Danish National Centre for Social Research
- Publication year:
- 2011
- Pagination:
- 252p., bibliog.
- Place of publication:
- Copenhagen
This report presents findings from the project Living Independently at Home: Reforms in organisation and governance of European home care for older people and people with disabilities (LIVINDHOME). The study provides an overview of recent and current reforms in the organisation and governance of home care systems in nine European countries, and analyses the intended and unintended results of these reforms, in particular, how the reforms have affected the organisation, supply and quality of care. The focus of the study is home care for older people and for people with disabilities. In countries that have more family-oriented welfare traditions (Austria, Germany, Italy, Ireland), comprehensive approaches to long-term care have started to develop only relatively recently. Despite increases in funding for long-term care, home care provision in Italy and Ireland remains highly fragmented, with major local variations in access to services. The second group of countries (Denmark, England, Finland, Norway, and Sweden) have had more or less comprehensive home care services in place for many years. These have been delivered by local authorities under a legislative framework set by central government. Reforms have here involved the introduction of market- and consumer-related mechanisms into the supply and delivery of home care.
Workplace health promotion in domiciliary care: an Austrian project
- Authors:
- HICKEL Susanne, PALKOVICH Tamara
- Journal article citation:
- Journal of Integrated Care, 13(4), August 2005, pp.26-33.
- Publisher:
- Emerald
This article reports practical experiences with workforce health promotion in domiciliary care arising from an ongoing EU-funded Austrian project. The auuthors review research-based findings on working conditions and indicate starting points for health-promoting measures. We describe the approach, and give insight into challenges and obstacles to workplace health promotion in this field of work. The issues may have strong relevance for the UK.
Impact of COVID-19 policy responses on live-in care workers in Austria, Germany, and Switzerland
- Authors:
- LEIBLFINGER Michael, et al
- Journal article citation:
- Journal of Long-Term Care, October 2020, pp.144-150. Online only
- Publisher:
- King's College London
- Place of publication:
- London
Context: The measures taken to counter the COVID-19 pandemic restricted the circular migration of live-in care workers between their countries of origin and the elderly persons’ households. Objective: In this comparative policy analysis, the impact of COVID-19 related policy measures for transnationally organised live-in care in Austria, Germany, and Switzerland is investigated. Method: Policy measures and media debates were analysed and inquiries with care workers, representatives of care agencies, unions, and activist groups were carried out between March and June 2020. Findings: In accordance with their institutionalisation of live-in care, Austria, Germany, and Switzerland responded differently to the challenges the pandemic posed to live-in care arrangements. However, all three countries focused on extending care workers’ rotas and re-establishing transnational mobility. These priorities subordinated the interests of care workers to those of care recipients. Furthermore, the measures remained short-term solutions that failed to acknowledge the fundamental flaws and inequalities of a care model that relies primarily on female migrant workers and wage differentials within Europe. Limitations: This policy comparison is based on an in-depth analysis of COVID-19 related policies, supplemented by inquiries among stakeholders with whom research had been done prior to the pandemic. More in-depth interviews are required to further substantiate the findings concerning their perspectives and gain insight into the longer-term effects of the pandemic. Implications: The pandemic has brought the flaws of the live-in care model to the fore. Countries need to rethink their fragile care policies, which build on social inequality and uninhibited transnational mobility. (Edited publisher abstract)
The long-term care workforce in Austria. Who are they and what do they do?
- Authors:
- RODRIGUES Ricardo, BAUER Gudrun, LEICHSENRING Kai
- Publisher:
- European Centre
- Publication year:
- 2018
- Pagination:
- 11
- Place of publication:
- Vienna
This policy brief examines the profile of long-term care workers in Austria, including information on demographic characteristics of long-term care workers, characteristics of clients and staffing ratios, daily working tasks, the reconciliation of work and family and a comparison of the main characteristics of long-term care employment between Austria, Germany and Sweden. It is one of two policy briefs which are based on the results of the NORDCARE survey to investigate the working conditions of the long-term care workforce in the home care and residential care sector in three regions of Austria. (Edited publisher abstract)
Home care in Austria: the interplay of family orientation, cash-for-care and migrant care
- Authors:
- ÖSTERLE August, BAUER Gudrun
- Journal article citation:
- Health and Social Care in the Community, 20(3), May 2012, pp.265-273.
- Publisher:
- Wiley
This article, based on policy documents and statistical data, discusses the development of the home care sector in Austria. It analyses what impacts the interplay of the traditional family orientation to care, a universal cash-for-care scheme and a growing migrant care sector have on formal home care in the country. Austria has seen a substantial increase in formal home care over the past two decades. This has been driven by clients using their increased purchasing power and by policy priorities emphasising the extension of home care. Migrant care work was regularised in 2007, and the analysis suggests that while migrant care has usually worked as a substitute for other care arrangements, migrant care can also become a more integral element of care schemes. The article concludes that family orientation, unconditional cash benefits and the use of migrant carers do not necessarily preclude the development of a strong social service sector. Future implications are discussed.