Exploring the home services utilization and its influencing factors for case closures in Taiwan long-Term care system

Objectives: In order to develop person-centered service delivery in the community, it is important to understand the causal relationships among older adults' personal factors, service utilizations, and the ability to reside in the community from a longitudinal perspective. This study aimed to examine the profile of home services utilization and the reasons for case closures in two years, as well as the related influencing factors, among home service recipients in southern Taiwan. Methods: We analyzed the long-Term care dataset of one southern metropolitan area from 2011- 2015, and the records of 9,889 persons aged 50 and over who received home services with an initial need assessment (TO). The Cox Regression Analyses were used to examine the potential risk factors for leaving the services. Results: The high rates of case closures included death (20%) and drop-out (41%), mainly due to the need to search for caregiving resources within family networks. In terms of the influencing factors for leaving the services, those who with non-low household incomes, informal caregiving burden and moderate cognitive impairments were more likely to drop out. Conclusions: This study provides empirical evidence of the high dropout rate and the importance of further investigations to explore the service gap in this context, especially the need to give more attention to those service users who then drop out of the system. (Taiwan J Public Health. 2018;37(5):539-553).