Study of the factors associated with the inability to perform household tasks among aged persons on the Ile-de-France. Application to the sub-regional planning of home-help services

The aim of this paper is to present the preliminary results of a planning project in the area of health and social services for the elderly, which makes it possible to estimate the number of persons likely to seek help from such services at the administrative area levels with decisional powers. This involves identifying predictors of disability from raw data routinely available in the census and at various administrative area levels, the municipality being the preferred level. From the epidemiological data collected at the regional level, an indicator of disability has been constructed. Initially, those factors possibly associated with disabilities were identified by regrouping the variables in four dimensions (discriminant analysis): socio-economic, physical environment, human environment, local administrative area environment (district data from census, medical-social services offered in the area, ect.). Subsequently, a logistic regression made it feasible to calculate the coefficients attached to these predictors of disability. In our sample, sex, age and level of housing amenities in the dwelling place appear to be predictors of disability. The application of the coefficients obtained at the region level--by means of an epidemiological approach to distributions by sex, age and dwelling amenities characterizing a municipality or group of municipalities (territorial approach)--enabled us to estimate the number of persons 65 and over likely to seek help from home-assistance services at whatever administrative area level chosen. In certain of its quantitative aspects, this mixed approach (individual and area) helps in determining need, the first step in the planning process.