Abstract:

An analysis is made concerning the relation of different factors to client transfer between levels of care in an area-based system of long-term care for the elderly and the disabled. Special emphasis is given to the transfer from non-institutional to institutional care. The analysis uses data collected through the application of the ASIM monitoring system from 1985 to 1991 in the municipality of Solna, Sweden. Factors analysed include age, sex, marital status co-habitation, accessibility of housing informal social support and different aspects of disability. Multivariate analysis regarding factors related to institutionalization - i.e. transfer from domiciliary care or sheltered housing to residential home or long-term hospital care/nursing home - showed level of disability, staff assessment of appropriate level of care and age to be the most significant factors. Dementia was the strongest individual disability factor with functional disability and incontinence also having some influence on the probability of transfer. Deficiencies in the social environment in terms of living alone, inadequate housing accessibility or lack of social support did not show up - presumably because they were adequately compensated for by the public home help services.