Eldercare in Sweden: issues in service provision and case management.
Sweden's extensive eldercare system emphasizes home and community-based care provided by municipal government. Recent policy reform is designed to improve the provision and coordination of long-term care by transferring the responsibility and resources for the health care component from regional to local government. Policy designed to help older people manage at home has emphasized formal care, but support for family caregivers is now receiving increased attention. Care managers in municipal eldercare are responsible for individual client need assessment and level of care determination. Recent reforms in service provision combined with a weaker economy in the 1990s have increased the importance of the care manager's role in Sweden. Many municipalities are now testing new forms of service delivery that focus on the roles of care managers. These include a purchaser-provider model in which the care manager decides on a package of care and purchases some of the services from private or public providers. Under this system the care manager has increased responsibility for monitoring outcomes and determining how resources are used more effectively.
Hokenstad
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MC
Case Western Reserve University, Cleveland, OH 44106-7164, USA.
Johansson
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D000368:Aged; D019090:Case Management / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D009111:Local Government; D008134:Long-Term Care / Q000458:organization & administration*; D013548:Sweden; D019037:Urban Health Services / Q000458:organization & administration