WITH RESPECT TO OLD AGE – RESEARCH VOLUME 1 115 Chapter 5 Poverty, Disability and the Use of Long-Term Care Services

The purpose of this study is to investigate the relationship between income levels and the use of long-term care services after taking account of disability, health status, availability of informal care and other conventional indicators of the need related circumstances of frail elderly people. Large numbers of studies have reported associations between poverty, health status and the utilisation of health services. In contrast, there are relatively few studies that examine the relationship between poverty, disability and the use of community or residential care. A reasonably large number of studies provide evidence that social class and other indicators of material circumstances are inversely related to disability but we have been able to identify only four studies that have tried to disentangle the relationships between poverty, disability and the use of services. These studies show that there is an association between low income and higher rates of service utilisation, but some report that income may cease to be statistically significant after taking account of disability. However, the ‘best ’ study on methodological criteria does report that receipt of income support has a significantly positive effect on the use of home care services independently of other needs-related circumstances such as disability and social circumstances. The specific aim of this study is to use the latest available data and the most appropriate statistical methods to undertake a more rigorous investigation of the relationship between income, disability, informal care and service utilisation than hitherto. The analyses are based on three data sets: the detailed elderly supplement of the General Household Survey for 1994/5; the PSSRU’s 1995 survey of admissions to residential care; an