Predictors of intensity of use of adult day care centers in people with cognitive impairment

Background Adult day care is an established concept in Germany for people with cognitive impairment; however, only a small fraction of people in need for care actually use adult day care. Studies so far highlighted some predictors for the use of adult day care; however, it remains unclear which factors are associated with the intensity of use. Objective To identify relevant predictors for the intensity of use of adult day care using the Andersen healthcare utilization model. Material and methods Data used were obtained within the project dementia in day care with psychosocial MAKS interventions (DeTaMAKS), which studied adult day care users with cognitive impairments and their family caregivers. A logistic regression was performed to predict frequent or low use of adult day care. Results The following factors were significantly associated with higher intensity of use: civil status of adult care user being widowed or single, higher educational level of caregiver, higher care level, longer duration of adult day care use and more mental and behavioral symptoms of the adult day care user. The sensitivity analysis for cohabiting dyads additionally showed a higher intensity of use with a lower age of the caregiver and shorter distance between place of residence and adult day care but not with respect to educational level of the caregiver and mental and behavioral symptoms of the user. Conclusion The results show a need for adult day care, which increases with caregivers being employed and users living outside of permanent relationships. A short distance to the adult care center as well as flexible care options may increase the frequency of use.