TRANSFERS BETWEEN LEVELS OF CARE IN A SYSTEM OF LONG-TERM-CARE FOR THE ELDERLY AND DISABLED

The pattern of transfers of clients between different levels of care i n an area-based system of long-term care for elderly and disabled peop le is described and analysed using data collected through a monitoring system, called ASIM, from 1985-1991 in the Municipality of Solna, Swe den. Transfers between levels of care occurred in both directions but the frequency of downward transfers was small compared to the number o f upward transfers - especially for sheltered housing and residential homes. For all levels of care there were great variations in disabilit y among the entering clients, suggesting non-systematic assessment pro cedures in connection with admission. An analysis of changes over time in the pattern of transfers illustrated the interdependence of the di fferent levels of care. Reduced resources in long-term hospital care r esulted in a near blocking of transfers from the residential homes and increased average disability for the admitted patients in general.