The determinants of time spent on self-care

PURPOSE: More input from the individual into the management of their health has the potential to reduce demand on the formal care system and improve health outcomes. A variety of interventions have been developed to encourage such 'self-care', particularly for populations with long-term conditions. However the equity consequences of such initiatives are relatively unknown as there is little evidence on the social and economic determinants of time spent on self-care.

KEY METHODS: We estimate the social and economic determinants of time spent on self-care. We also examine whether patients spend time on self-care because they are compensating for lack of access to formal health care. We undertook regression analyses of eight self-care and formal care measures from a dedicated survey of 300 patients with long-term conditions.

MAIN RESULTS: We found that higher income is associated with less time spent on self-care. Various measures of access to formal health care are found to not be associated with time spent on self-care.

MAIN CONCLUSION: People from a lower socioeconomic position spend more time managing their condition even when there is universal entitlement to health care.