A district-wide examination of 75-year olds suggests discrimination in the provision of services.

Abstract

The aim of this study was to assess the adequacy of existing services across a whole health district for those aged 75 years, in an attempt to detect shortfalls and biases in the provision of services. This study was carried out as a cross-sectional survey using community based nurses in the county of South Glamorgan. 1376 people in their 75th year who were registered with a general practitioner were visited, and their problems assessed by community based nurses. There was a marked difference in the results of the assessment for different services. It was estimated that 76% of the 75-year olds would benefit from additional health services, and 37% from social services. There was a striking difference between the services in the proportion of people whose problems were satisfactorily solved, according to the criteria used by the community nurses. The proportion of problems that were solved varied according to the degree of dependency of the individuals, and the service involved. Some services showed a clear trend to care more for dependent people; services with a relatively undeveloped home delivery system seemed likely to discriminate against people who were dependent.