Formal and informal care received by middle-aged and older adults with chronic conditions in Canada: CLSA data.

Wei Zhang,Huiying Sun,Andrea Gruneir

doi:10.1371/journal.pone.0235774

Abstract

Middle-aged and older adults are more likely to suffer from chronic conditions, which can increase their need for both formal and informal care. This study seeks to assess and compare the extent to which the use of formal and informal care is attributed to different chronic conditions among middle-aged and older women and men in Canada. We used baseline data from the Canadian Longitudinal Study on Aging (CLSA). Outcomes of interest were the number of hours of formal care and informal care received during the past 12 months. All chronic conditions were first classified according to existing classification frameworks. If total formal and informal care hours for a particular condition differed greatly from other conditions, we considered it as a stand-alone classification. We used a two-part model consisting of a logistic regression for the probability of receiving formal/informal care and a generalized linear model for the hours of formal/informal care for those who received care. Our final analytic sample was 23,206 women and 22,903 men who did not have missing data. Among the 16 chronic conditions considered, multiple sclerosis, memory problems, Parkinsonism, and stroke had the greatest average marginal effects on overall hours of formal care among women (53.07, 13.95, 9.13 and 8.14 incremental hours annually, respectively) and men (152.17, 8.13, 13.95 and 6.00 incremental hours). Similarly, the average marginal effects of these four conditions on informal care were the greatest (77.78, 29.52, 26.18 and 34.95 incremental hours for women and 133.94, 34.99, 104.86 and 17.85 incremental hours for men). Chronic conditions, especially multiple sclerosis, Parkinsonism, memory problems, and stroke, are associated with substantial time of formal and informal care in middle-aged and older women and men. Findings will help decision-makers assess the potential impact of chronic disease prevention and management programs in an aging population.

Highlights

The prevalence of people with health problems, especially chronic conditions, increases with age [1]
It is important for policy makers to understand the demand for formal and informal care by different chronic conditions as this can help inform the allocation of resources to meet the increasing demands of an aging population
Our study population consists of all respondents who participated in the Canadian Longitudinal Study on Aging (CLSA) at baseline

Summary

Introduction

The prevalence of people with health problems, especially chronic conditions, increases with age [1]. In Canada, about 44% of care receivers received informal care only, 12% relied on formal care only, and the remaining received both formal and informal care [6] Both formal and informal care contribute significantly to the healthcare system as this enables care receivers with health conditions, disabilities, or age-related needs to remain at home, reducing the need for other health care service utilization such as nursing home, hospital care and physician visits [7,8,9]. Middle-aged and older adults are more likely to suffer from chronic conditions, which can increase their need for both formal and informal care.

Methods

Results

Conclusion