DISABILITY TRANSITIONS IN AN AREA-BASED SYSTEM OF LONG-TERM-CARE FOR THE ELDERLY AND DISABLED

Objective: To describe patterns of individual disability development a nd mortality in an area-based system for long-term care of the elderly and disabled. Data sources and study setting: Yearly surveys accordin g to the ASIM system from 1985 to 1991 of all citizens of Solna, Swede n, receiving long-term care services from the municipality and/or the county council. Study design: Linkage of individual assessments concer ning disability and level of care from one survey to the next, using n ational registration numbers. Data collection: Registrations according to the ASIM system concerning services actually provided, assessed ne ed of services, social environment and disability were collected by th e staff responsible for the services provided. Principal findings: Mor tality was shown to be strongly connected to disability. Disability tr ansitions occurred in both directions for all age groups, but the aver age rate of disability increase rose with advancing age. Rapid disabil ity development was shown in a multivariate analysis to be connected t o institutional care and change in the level of care between surveys. Conclusions: Data describing disability development can be used for pl anning purposes, either directly or with the help of a simulation mode l. More research seems to be needed with regard to the influence of th e level of care and of transfers on disability development.