A DISTRICT-WIDE EXAMINATION OF 75-YEAR OLDS SUGGESTS DISCRIMINATION IN THE PROVISION OF SERVICES

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 stu dy was carried out as a cross-sectional survey using community based n urses in the county of South Glamorgan. 1376 people in their 75th year who were registered with a general practitioner were visited, and the ir problems assessed by community based nurses. There was a marked dif ference in the results of the assessment for different services. It wa s estimated that 76% of the 75-year olds would benefit from additional health services, and 37% from social services. There was a striking d ifference between the services in the proportion of people whose probl ems were satisfactorily solved, according to the criteria used by the community nurses. The proportion of problems that were solved varied a ccording to the degree of dependency of the individuals, and the servi ce involved. Some services showed a clear trend to cave more for depen dent people; services with a relatively undeveloped home delivery syst em seemed likely to discriminate against people who were dependent.