Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-03T02:56:00.625Z Has data issue: false hasContentIssue false

Transfers between Levels of Care in a System of Long-term Care for the Elderly and Disabled

Published online by Cambridge University Press:  29 November 2010

Mårten Lagergren
Affiliation:
Ministry of Health and Social Affairs, Stockholm

Abstract

The pattern of transfers of clients between different levels of care in an area-based system of long-term care for elderly and disabled people is described and analysed using data collected through a monitoring system, called ASIM, from 1985–1991 in the Municipality of Solna, Sweden. Transfers between levels of care occurred in both directions but the frequency of downward transfers was small compared to the number of upward transfers – especially for sheltered housing and residential homes. For all levels of care there were great variations in disability among the entering clients, suggesting non-systematic assessment procedures in connection with admission. An analysis of changes over time in the pattern of transfers illustrated the interdependence of the different levels of care. Reduced resources in long-term hospital care resulted in a near blocking of transfers from the residential homes and increased average disability for the admitted patients in general.

Résumé

Les modes de référence de patients entre différents niveaux de soins dans un système local de soins de longue durée pour personnes âgées et handicapées sont décrits et analysés à l'aide des données collectées de 1985 à 1991 dans la commune de Solna grâce au système de contrôle appelé ASIM. Ces références entre niveaux de soins avaient lieu dans les deux sens, mais la fréquence des transferts vers le bas était faible comparée au nombre de transferts vers le haut – en particulier pour les foyers-logements et les résidences-hôtels. Pour tous les niveaux de soins, on a constaté de grandes variations dans le degré d'incapacité des personnes prises en charge, suggérant le charactère non-systématique des procédés d'évaluation lors de l'admission dans les services de soins. Une analyse des changements intervenus avec le temps dans les modes de référence a illustré l'interdepéndence des différents niveaux des soins. La réduction des ressources des services de soins hospitaliers de longue durée a eu pour résultats un arrêt presque total des références à partir des résidences-hôtels et une augmentation générale de l'incapacité moyenne des patients pris en charge.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 1996

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

Cohen, M., Tell, E., Bishop, C., Wallack, S., & Branch, L. (1989). Patterns of nursing home use in a prepaid managed system: The continuing care retirement community. The Gerontologist, 29, 7480.CrossRefGoogle Scholar
Goldberg, E.M., & Connelly, N. (1982). The effectiveness of social care for the elderly. London: Heinemann Educational Books.Google Scholar
Lagergren, M. (1993a). ASIM — a system for monitoring and evaluation of the care of the elderly and disabled in a municipality. Health Services Research, 28, 2744.Google Scholar
Lagergren, M. (1993b). The residential home — What difference does it make? Scandinavian Journal of Social Welfare, 2, 2532.CrossRefGoogle Scholar
Lagergren, M. (1994a). De-institutionalisation and aging — some results from monitoring the effects in an area-based system of long-term care for the elderly and disabled. Health and Social Care in the Community, 2, 1930.CrossRefGoogle Scholar
Lagergren, M. (1994b). Allocation of care and services in an area-based system of long-term care for the elderly and disabled. Aging and Society, 14, 357381.CrossRefGoogle Scholar
Lagergren, M. (1994c). Disability development and the structure of care — some results from simulation of an area-based system of long-term care for elderly people. Health Policy, 29, 229246.CrossRefGoogle ScholarPubMed
Liu, K., & Manton, K.G. (1984). The characteristics and utilization pattern of an admission cohort of nursing home patients. The Gerontologist, 24, 7076.CrossRefGoogle ScholarPubMed
Mackeprang, B., & Brauer, E. (1977). Changes in Age and Need for Care among Patients in a Geriatric Institution During a Two-Year Period. Scandinavian Journal of Social Medicine, 5, 6772.Google Scholar
Rhys Hearn, C. (1985). Comparison of the Nursing Dependency of Elderly Patients in a Number of Different Residential Settings: I. Australia. In Tilquin, C. (Ed.), Proceedings of the 1st International Conference on Systems Science in Health/Social Services for the Elderly and the Disabled (SYSTED 83). Montréal: Science des Systèmes.Google Scholar
Stark, A., Kliewer, E., Gutman, G., & McCashin, B. (1984). Placement changes in longterm care: Three years experience. American Journal of Public Health, 74, 459–63.CrossRefGoogle ScholarPubMed
Tilquin, C., & Vanderstraeten, G. (1988). Health and Social Resources Planning Based on Activity Analysis — A Quebec Experience in the Long-Term Care and Services Sector for the Elderly. In Zweifel, P. (Ed.), Beiträge zur Gesundheitsökonomie. Gerungen: Bleicher Verlag.Google Scholar
Wade, B. (1985). Comparison of the Nursing Dependency of Elderly Patients in a Number of Different Care Settings: II. United Kingdom. In Tilquin, C. (Ed.), Proceedings of the 1st International Conference on Systems Science in Health/Social Services for the Elderly and the Disabled (SYSTED 83). Montréal: Science des Systèmes.Google Scholar