Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T10:53:49.244Z Has data issue: false hasContentIssue false

Strategies for an Ageing Population: Expanding the Priorities Discussion

Published online by Cambridge University Press:  14 November 2008

Mats Thorslund
Affiliation:
Department of Social Work, Stockholm UniversityS-10691 Stockholm, Sweden.
Marti G. Parker
Affiliation:
Department of Social Work, Stockholm UniversityS-10691 Stockholm, Sweden.

Abstract

The growing number of oldest old has increased the need for social services and medical care in many countries during the last decade. These needs have been met with various strategies to make more effective and efficient use of resources. In many ways these changes have been successful, but at the same time the amount of success correlates negatively to the potential for further gains. That is, when the slack in the system has been drawn in, it is doubtful whether further gains can be made with these strategies. So what can be done if the public resources are restricted and needs continue to increase? Adequate solutions will require a wide perspective encompassing all the various services needed by elderly people. Decisions made in one sector necessarily have repercussions in other service areas. It is also essential to recognize the differences between sectors; guidelines and strategies developed within the medical sector are not always applicable in the social services sector. With Sweden as an example, the organizational and administrative changes that have occurred during the last decades are presented along with arguments for extending the discussion of strategies and priorities to include all kinds of service to the elderly population.

Type
Research Article
Copyright
Copyright Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ackerby, S. 1993. Den demografiska utvecklingens betydelse for konsumtionen av hälso- och sjukvård (The importance of demographic developments in the utilization of health care), Memorandum. Ministry of Social Affairs, Stockholm.Google Scholar
Baldock, J. and Evers, A. 1991. Innovations and care of the elderly: The front line of change for social welfare services. Ageing International, 06, 821.CrossRefGoogle Scholar
van den Bergjeths, A. and Thorslund, M. 1994. Will resources for elder care be scarce? Hastings Center Report, 24, 610.CrossRefGoogle Scholar
Berleen, G. 1993. Minskade vard kostnader i Sverige (Decreased costs of care in Sweden). Spri-informerar, 3, 45.Google Scholar
Branch, L. 1993. No evidence of short term compression of morbidity. In: Thorslund, M. (Ed.) De äldres v˚rdbehov år 2000 (The need for care of elderly persons in the year 2000). National Board of Health and Welfare, Stockholm.Google Scholar
Calltorp, J. 1989. Prioritering och beslutsprocess i sjukvårdsfrågor. Några drag i de senaste decenniernas sjukvårdspolitik (Priority setting and the decision making process in health care. Some postwar characteristics of health policy in Sweden). Academic thesis. Department of Social Medicine, Uppsala.Google Scholar
Choices in Health Care 1992. A report by the Government Committee on Choices in Health Care. Ministry of Welfare, Health and Culture Affairs, Rijswijk.Google Scholar
Culyer, A.J. 1991. Health care and health care finance in Sweden: The crisis that never was; the tensions that ever will be. Occasional Paper Nr 33 11. SNS, Stockholm.Google Scholar
Easterlin, R. A. 1991. The economic impact of prospective population changes in advanced industrial countries: An historical perspective. Journals of Gerontology: Social Sciences, 46, S299309.CrossRefGoogle ScholarPubMed
Evans, R. G. 1991. Reflections on the revolution in Sweden. In A.J., Culyer, Ed., International Review of the Swedish Health Care System. SNS, Stockholm.Google Scholar
Fozard, J. L., Metter, E.J. and Brant, L.J. 1990. Next steps in describing aging and disease in longitudinal studies. Journal of Gerontology: Psychological Sciences, Special Issue, 45, 116127.CrossRefGoogle ScholarPubMed
Fries, J. 1983. The compression of morbidity. Milbank Memorial Fund Quarterly, 61, 347419.Google ScholarPubMed
Fries, J. 1989. The compression of morbidity: Near or far? Milbank Memorial Fund Quarterly, 67, 208232.CrossRefGoogle ScholarPubMed
U.-G., Gerdtham 1993. The impact of aging on health care expenditure in Sweden. Health Policy, 24, 18.Google Scholar
U.-G., Gerdtham and B., Jönsson 1991. Health care expenditure in Sweden – an international comparison. Health Policy, 19, 211228.Google Scholar
Guralnik, J. M. 1991. Prospects for the compression of morbidity. Journal of Aging and Health, 3, 138154.CrossRefGoogle Scholar
Health Services Commission 1992. Prioritized list of health services. Health Services Commission, Portland, Oregon.Google Scholar
Johansson, L. and Thorslund, M. 1992. Care needs and sources of support in a nationwide sample of elderly in Sweden. Zeitschrift fur Gerontologie, 25, 5762.Google Scholar
Kaplan, G. A. 1991. Epidemiologic observations on the compression of morbidity. Journal of Aging and Health, 3, 155171.CrossRefGoogle Scholar
Kirk, H. 1992. Geriatric medicine and the categorisation of old age – the historical linkage. Ageing and Society, 12, 483497.CrossRefGoogle Scholar
Lagergren, M. 1994. De-institutionalization and ageing: some results from monitoring the effects in an area-based system of long-term care for elderly people and people with disabilities. Health and Social Care, 2, 1930.CrossRefGoogle Scholar
Leidl, R. 1992. Health economic issues relevant to countries with aging populations. World Health Statistics Quarterly, 45, 95108.Google ScholarPubMed
Lundvall, O. 1988. Sjukvårdskonsumtion och sjukdomspanorama vid en medicinklinik perioden 1953–1986. (Medical care consumption and disease panorama from a medical ward 1953–1986). Läkartidningen, 85, 42804287.Google Scholar
Lundvall, O., Sjöö, M., Tjernell, Å. and Thorslund, M. 1993. Medicinkliniken och de äldre efter Ädel-reformen (Medical wards after the reforms for the elderly). National Board of Health and Welfare, Stockholm. Ädelutvärderingen, 93 (9), 5973.Google Scholar
Manton, K. G. 1990. Mortality and morbidity. In Binstock, R. H. and George, L. K. (eds) Handbook of Aging and the Social Sciences. Academic Press, San Diego, 6490.Google Scholar
Ministry of Social Affairs 1989. Rapport från äldredelegationen (Report from the Commission for the Elderly). Ds 1989: 27. Ministry of Social Affairs, Stockholm.Google Scholar
NOU 1987. Retningslinjer for prioritering innen norsk helsevesen (Guidelines for setting priorities in Norwegian health care). Ministry of Social Affairs, Oslo.Google Scholar
OECD 1987. Financing and delivering health care – a comparative analysis of OECD countries. OECD Social Policy Studies 4. OECD, Paris.Google Scholar
OECD 1990. Health care systems in transition: the search for efficiency. OECD Social Policy Studies 7. OECD, Paris.Google Scholar
Parker, M. G. and Thorslund, M. 1993. The provision of assistive technology for the elderly in Sweden. Technology and Disability, 2, 4549.CrossRefGoogle Scholar
Saltman, R. B. 1991. Emerging trends in the Swedish Health System. International Journal of Health Services, 21, 615623.CrossRefGoogle ScholarPubMed
SOU 1993. Vårdens svåra val. Rapport från utredningen om prioriteringar inon hälso- och sjukvården (Difficult choices in health care Report concerning setting of priorities in medical care). Ministry of Social Affairs, Stockholm, 93.Google Scholar
Styrborn, K. and Thorslund, M. 1993. “Bed-blockers” – delayed discharge of hospital patients in a nationwide perspective in Sweden. Health Policy, 26, 155170.CrossRefGoogle Scholar
Sundman, L. 1990. Utvärdering av Hudiksvallmodellen för äldreomsorg (An evaluation of the Hudiksvall model of care of the elderly). Academic thesis. Department of Social Medicine, Uppsala.Google Scholar
Svanborg, A. 1988. The health of the elderly population: results from longitudinal studies with age-cohort comparisons. In Ciba Foundation Symposium 134, Research and the Ageing Population. Wiley, Chichester.Google Scholar
Szebehely, M. 1993. Hemtjänst eller anhörigvård? Förändringar under 80-talet (Home services for elderly persons or their families? Changes during the eighties). National Board of Health and Welfare, Stockholm.Google Scholar
Thorslund, M. 1988. The de-institutionalization of care of the elderly: some notes about implementations and outcome of a Swedish case-study. Health Policy, 10, 4456.CrossRefGoogle ScholarPubMed
Thorslund, M. 1991. The increasing number of very old people will change the Swedish model of the welfare state. Social Sciences and Medicine, 32, 455464.CrossRefGoogle ScholarPubMed
Thorslund, M. 1993 a. Home care in Sweden: past and future trends. In Evers, A. and van der Zanden, G. H. (eds): Better care for dependent people living at home: meeting the new agenda in services for the elderly. Netherlands Institute of Gerontology, Bunnik, 97114.Google Scholar
Thorslund, M. 1993 b. Äldres flyttningar till service och vård (Admissions of elderly people to institutions and special housing). Stockholm: National Board of Health and Welfare, Ädelutvärderingen, 93 (9), 745.Google Scholar
Thorslund, M., Norström, T. and Wernberg, K. 1991. The utilization of home help: A multivariate analysis. The Gerontologist, 31, 116119.CrossRefGoogle ScholarPubMed
Thorslund, M. and Parker, M. G. 1994. Care of the elderly in the changing Swedish welfare state. In Challis, D. and Davis, B. (eds): Community Care: New agendas and challenges from the UK and overseas. Ashgate, Aldershot, 249263.Google Scholar
Twigg, J. 1993. The interweaving of formal and informal care: policy models and problems. In Evers, A. and van der Zanden, G. H. (eds): Better care for dependent people living at home: meeting the new agenda in services for the elderly. Netherlands Institute of Gerontology, Bunnik, 115132.Google Scholar