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Anglo-American differences in care for the elderly: reflections on a visiting professorship

Journal of the American Geriatrics Society

Author: Evans, J. G.
Type: Journal Article
Year: 1982


Comparison of care systems for the elderly in Great Britain & the U.S. are of interest because although the two countries share the same human values, their approaches to service organization-respectively, nationalized & entrepreneurial-are very different. Great Britain's nationalized system has the disadvantages of a centralized & cumbersome bureaucracy, but the need in the U.S. for surveillance of the entrepreneurial system to prevent fraud & to contain costs has resulted in an equally cumbersome bureaucracy. The entrepreneurial system does, however, gain in terms of creative administration aiming to achieve defined ends, whereas British administration is primarily concerned with imposing procedures rather than attaining objectives. Nonetheless, the British elderly have access to services as a national right rather than a local privilege. Styles of medical education also differ between the two countries-Great Britain still tending toward the apprenticeship system, & the U.S. toward more explicit teaching programs. Medical education in Great Britain reflects the existence of a growing specialty of geriatric medicine, which seems unlikely to be established in the U.S. The separation of hospital general medical services for the elderly from those for other adult ages in Great Britain has brought some disadvantages as well; eg, British medical gerontological research is dominated by the problems of the aged, rather than the study of aging. The elderly probably have more to gain from belonging to the human race than from being awarded special status.

Further Details

Full Title: Journal of the American Geriatrics Society
Pages: 348-351
Volume: 30
Issue: 5
Accession Number: 1.4.03
Keywords: United Kingdom, North America, older
Reads: 200