TRANSFERRING TO AN INSTITUTION - AN ANALYSIS OF FACTORS BEHIND THE TRANSFER TO INSTITUTIONAL LONG-TERM-CARE

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