[Separation of housing and care: more or less care? Consequences for health care services utilization by the elderly].
The Dutch policy for the care of the elderly has been mainly characterised by the aim to improve the possibility for elderly people to live independently for as long as possible. One measure that has been taken to achieve this goal is the separation of the financing of care from the accommodation in which care is given. Recent discussions have brought to light some possible positive and negative effects of this separation on the use of care. It is, however, largely unknown to what extent there are differences concerning the nature and intensity of care and the type of caregivers provided to dwellers of houses where care and housing are separated (so-called 'life-time houses') and the elderly who live in homes for residential care and nursing homes. To gain insight in this matter an explorative study was conducted in Rotterdam of the use of several health facilities by matching 35 dwellers of 'life-time houses' on the criteria age, health needs and social status with 35 dwellers of residential care homes and nursing homes. On the basis of interviews, questionnaires and patient records data were collected and analysed on the nature and amount of help that has been given (per minute per week) and the kind of caregiver. The main finding is that the use pattern differs between the research groups. Dwellers of 'life-time houses' generally make more use of some care facilities and make more use of different types of care and caregivers. These differences however do not seem to be exclusively caused by the separation of housing and care.
Fabbricotti
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Erasmus Universiteit Rotterdam, Instituut Beleid en Management Gezondheidszorg, Postbus 1738, 3000 DR Rotterdam.
Huijsman
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D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006291:Health Policy / Q000191:economics*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000191:economics* / Q000706:statistics & numerical data