Jasmine Mah|Susan Stevens|Janice Keefe|Kenneth Rockwood|Melissa K. Andrew
Social factors influencing utilization of home care in community-dwelling older adults: a scoping review
London School of Economics and Political Science|Mount Saint Vincent University|Mount Saint Vincent University|Dalhousie University|Dalhousie University
abstract background older adults want live home long possible even face circumstances limit autonomy home care services reflect emergent preference allowing older adults age place familiar settings rather receiving care chronic health conditions ageing needs institutionalized setting numerous social factors generally studied isolation associated home care utilization even social circumstances complex factors collectively influence home care use patterns remains unclear objectives provide broad comprehensive overview social factors influencing home care utilization evaluate influence discrete social factors patterns home care utilization communitydwelling older adults highincome countries methods scoping review conducted six electronic databases records published 2010 2020 additional records obtained hand searching review articles reference lists included studies documents international organisations narrative synthesis presented complemented vote counting per social factor harvest plots evaluation aggregated findings determine consistency across studies results total 2365 records identified 66 met inclusion criteria 35 discrete social factors grouped four levels influence using socioecological model individual relationship community societal levels grouped according outcome interest home care propensity intensity across studies social factors consistently showing association positive negative equivocal pattern home care propensity age ethnicityrace selfassessed health insurance housing ownership housing problems marital status household income children informal caregiving social networks urbanrural area age education personal finances living arrangements housing ownership associated home care intensity also variable patterns utilization additional community societal level factors identified relevant lacking consistency across literature included rurality availability community services methods financing home care systems cultural determinants conclusion first literature review bringing together wide range reported social factors influence home care utilization confirms social factors influence home care utilization complex interactions distinguishes level influences factors affect patterns use discusses policy implications home care reform