DISABILITY DEVELOPMENT AND THE STRUCTURE OF CARE - SOME RESULTS FROM SIMULATION OF AN AREA-BASED SYSTEM OF LONG-TERM-CARE FOR ELDERLY PEOPLE

In order to study the dynamic properties of an area-based system of lo ng-term care for elderly people a simulation model was developed. The model describes the system of care in terms of the number of persons p er level of care, age group, gender and degree of disability. Flows be tween levels of care and changes in degree of disability are regulated by Markovian transition matrices. The simulation proceeds by calculat ing for each year the changes in the system state depending on the inf low of new clients, the transfers of clients between levels of care, t he changes in disability, mortality and the exist of clients from the care system. Data for the simulation model have been collected during the period 1985-1991 through the application of the ASIM (Aldre SIMule ring meaning 'Elderly Simulation') monitoring system in the municipali ties of Solna and Sigtuna, Sweden. Using the observed relationship in Solna between disability development and level of care, it is estimate d by the simulation that substituting the residential homes in Solna f or sheltered housing would reduce the total care system work-load by a bout 5%. Approximately the same result is obtained when using the Sigt una set of data.