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Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden

Lagergren, Mårten; Fagerström, Cecilia LU ; Sjölund, Britt Marie; Berglund, Johan LU ; Fratiglioni, Laura; Nordell, Eva LU ; von Strauss, Eva; Wimo, Anders and Elmståhl, Sölve LU (2016) In Aging clinical and experimental research 28(1). p.147-158
Abstract

The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontaltarget efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were... (More)

The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontaltarget efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001–2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70–90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40–50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern—it was almost 100 % in all areas for IADL dependency, but only 50–60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Eldercare, Long-term care, Older people, Public care, Target efficiency, Urban/rural differences
in
Aging clinical and experimental research
volume
28
issue
1
pages
12 pages
publisher
Kurtis
external identifiers
  • Scopus:84962052877
ISSN
1594-0667
DOI
10.1007/s40520-015-0369-5
language
English
LU publication?
yes
id
a71fa866-55fd-402d-a773-5e186914bfbd
date added to LUP
2016-05-26 12:51:58
date last changed
2016-09-20 03:07:55
@misc{a71fa866-55fd-402d-a773-5e186914bfbd,
  abstract     = {<p>The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontaltarget efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001–2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70–90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40–50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern—it was almost 100 % in all areas for IADL dependency, but only 50–60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.</p>},
  author       = {Lagergren, Mårten and Fagerström, Cecilia and Sjölund, Britt Marie and Berglund, Johan and Fratiglioni, Laura and Nordell, Eva and von Strauss, Eva and Wimo, Anders and Elmståhl, Sölve},
  issn         = {1594-0667},
  keyword      = {Eldercare,Long-term care,Older people,Public care,Target efficiency,Urban/rural differences},
  language     = {eng},
  month        = {02},
  number       = {1},
  pages        = {147--158},
  publisher    = {ARRAY(0x7c9c168)},
  series       = {Aging clinical and experimental research},
  title        = {Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden},
  url          = {http://dx.doi.org/10.1007/s40520-015-0369-5},
  volume       = {28},
  year         = {2016},
}