Determinants of Discretionary and Non-Discretionary Service Utilization among Caregivers of People with Dementia: Focusing on the Race/Ethnic Differences

• Published in: Home health care services quarterly 2021, Vol.40 (1), p.75-92
• Main Authors: Xu, Ling, Lee, Yura, Kim, Bum Jung, Chen, Lin
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer's disease; Andersen model; Black or African American; Black People - ethnology; Black People - psychology; Black People - statistics & numerical data; Caregivers; Caregivers - psychology; Caregivers - statistics & numerical data; caregivers of people with dementia; Dementia; Dementia - complications; Dementia - psychology; discretionary service; Diversion programs; Female; Hispanic Americans; Hispanic or Latino - psychology; Hispanic or Latino - statistics & numerical data; Humans; Logistic Models; Male; Middle Aged; Needs; non-discretionary service; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Racial differences; Racial Groups - ethnology; Racial Groups - statistics & numerical data; service utilization; White People - ethnology; White People - psychology; White People - statistics & numerical data
• ISSN: 0162-1424; 1545-0856; 1545-0856
• DOI: 10.1080/01621424.2020.1805083

Using Andersen's behavioral model of service utilization, this study aimed to understand how predisposing, enabling, and need factors were associated with two types of service utilization among caregivers of people with dementia. Caregiver participants (N = 637) were from the Resources for Enhancing Alzheimer's Caregivers Health (REACH II) study. Binary logistic and linear regression analyses were conducted to predict whether participants used services and the frequency of such service utilization. Results showed that some enabling and need factors were significantly associated with both discretionary and non-discretionary service utilization. Results also indicated some need factors were significant factors of the frequency of use for both discretionary and non-discretionary services. In addition, being Hispanic or African American moderated the association between some enabling or needs factors and service utilization. Practice attention needs to be paid on several enabling and needs factors among Hispanic and African American caregivers of people with dementia.