Disability transitions in an area-based system of long-term care for the elderly and disabled

Abstract

Objective: To describe patterns of individual disability development and mortality in an area-based system for long-term care of the elderly and disabled. Data sources and study setting: Yearly surveys according to the ASIM system from 1985 to 1991 of all citizens of Solna, Sweden, receiving long-term care services from the municipality and/or the county council. Study design: Linkage of individual assessments concerning disability and level of care from one survey to the next, using national registration numbers. Data collection: Registrations according to the ASIM system concerning services actually provided, assessed need of services, social environment and disability were collected by the staff responsible for the services provided. Principal findings: Mortality was shown to be strongly connected to disability. Disability transitions occurred in both directions for all age groups, but the average rate of disability increase rose with advancing age. Rapid disability development was shown in a multivariate analysis to be connected to institutional care and change in the level of care between surveys. Conclusions: Data describing disability development can be used for planning purposes, either directly or with the help of a simulation model. More research seems to be needed with regard to the influence of the level of care and of transfers on disability development.