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

Keywords

Long-term CareMonitoringTransferElderlyDisabled.Soins de longue duréesurveillanceréférenceaînésincapacités.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 15 , Issue 1 , Spring/printemps 1996 , pp. 97 - 111
Copyright
Copyright © Canadian Association on Gerontology 1996

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