A social network cares

Summary Health care services can enable persons with a physical disability to live independently. Research showed that not all persons with a need for these services, actually used them. Our study investigated whether persons may not apply for these services, because submitting an application is difficult for them. Whether the social network of physically disabled persons enables persons to submit an application has also been studied. The research questions used to study these subjects are: -‘To what degree is the application for health care services a bottleneck for physically disabled persons?’ and; -‘Does the social network exert influence on the application for health care services of physically disabled persons?’ These research questions have been studied with two data sets (Amenities and Services Utilization Survey 2003 and Amenities and Services Utilization Survey for the Physically Disabled 2004) of the Social and Cultural Planning Office of the Netherlands (Sociaal en Cultureel Planbureau). The last research question has been studied in two different ways, because of shortcomings in the secondary data. The first approach investigated whether physically disabled persons received support of their social network when submitting an application, if so, from whom and why. The second approach used the Andersen model (1995) to study the relation between the presence of a social network and the application for professional home care and housing adaptations. The use of professional home care has also been studied due to shortcomings in the secondary data. In addition, the second approach investigated which groups of variables of the Andersen model explained the variance in the utilization of professional home care and the application for housing adaptations most. Moreover, it has been investigated whether having problems with submitting an application is directly related to the actual use of and application for professional home care and housing adaptations. Both research questions have been examined with bivariate analysis and multivariate logistic analysis. Our results showed that submitting an application for health care services was a bottleneck for many physically disabled persons. Often, persons were not well informed on the application process, especially elderly persons and those with a low educational level did not search information. The majority of physically disabled persons, in particular middle aged persons, elderly, women, those with a low educational level and those with a low income, did not use the internet to search information. In addition, submitting an application could be a bottleneck, because many physically disabled people, especially those with a moderate disability, shied away from applying for health care services. Moreover, some had difficulties with or could not even perform administrative activities needed to submit an application. This particularly applied to those with a severe physical disability and those with a low educational level. The first approach showed that a social network positively exerted influence on the application for health care services, because many people with a physical disability received support of their social network when submitting an application. Receiving support was associated with severe physical disability, old age and a low educational level. Persons, in particular elderly and single persons, mainly received this support, because they did not know how or where to apply for health care services. Often, a child or parent lent support. This especially related to young adults, elderly, women, single persons, and those who have a ‘stronger’ social network. A partner also lent support, in particular to the ones who did not receive support of a child or parent. Not all physically disabled persons could rely on their social network for support. This especially applied to persons younger than 75 years and singles. Next, our results showed that not all persons who want to use professional home care or housing adaptations submitted an application for this. Persons who applied for professional home care in particular are those with a severe physical. Especially elderly and those who do not shy away from submitting an application applied for housing adaptations. Associated with the utilization of professional home care were severe physical disability, old age, gender, low income, not having a partner and not shying away from submitting an application. The second approach also showed that a social network positively exerted influence on the use of professional home care and the application for housing adaptations. More persons with a physical disability who often have contact with their family used professional home care. Moreover, more single persons who live near by their family applied for housing adaptations than others. In addition, our results indicated that predisposing characteristics and to a less degree enabling resources explained the use of professional home care and the application for housing adaptations 7 most, even more than need. Therefore, next research on the use of and application for health care services should include social network characteristics. To reduce the inequality in the utilization of professional home care and the application for housing adaptations, information on health care services and the application process should be actively distributed in different ways to both potential users of these services and to their social network. Further, local governments have to lend support to persons who cannot submit an application themselves and lack social support. Lastly, it is desirable to aim these policies at specific groups without many resources, such as persons with a low educational level or single persons.