Characteristics and Services Utilization by Users of Home Care Services in Catalonia: A Retrospective Cohort-Based Study of a Social Program for Dependent Individuals

Abstract

Abstract Introduction: Home Care Services (HCS) for care-dependent individuals enable their independent lives at home. We aimed to characterize users and evaluate the impact of social HCS for dependent individuals. Methods: Retrospective study including all social HCS recipients for individuals with the official recognition of dependency from Catalonia using 2018–2019 data from the Autonomy and Dependency Care System and the Catalan Health Surveillance System. Variables were social and healthcare services utilization and expenditure. HCS recipients were compared to non-recipients. Changes in services utilization and expenditure before and after HCS were estimated. Results: The 48,885 individuals who received HCS in 2019 were mostly >84 years, women, and had moderate dependency. Recipients’ prevalence was higher among low-/very-low-income individuals. HCS users had a higher morbidity burden than non-recipients with increased healthcare service utilization and associated expenditures. After HCS initiation, Telecare, day center, and most healthcare services utilization increased. Social and healthcare service-associated expenditures increased from a mean of 535 to 867 €/individual/month after HCS initiation, mostly due to HCS. Conclusions: Social HCS dependency recipients were overall very old, with moderate dependency, low-income, high morbidity, and intensive use of healthcare services. HCS is associated with increased social service-associated expenditures and modestly decreased healthcare-associated expenditures.