Life on the edge: patterns of formal and informal help to older adults in the United States and Sweden.
OBJECTIVE
Our objective in this study was to compare assistance received by individuals in the United States and Sweden with characteristics associated with low, moderate, or high 1-year placement risk in the United States.


METHODS
We used longitudinal nationally representative data from 4,579 participants aged 75 years and older in the 1992 and 1993 waves of the Medicare Current Beneficiary Survey (MCBS) and cross-sectional data from 1,379 individuals aged 75 years and older in the Swedish Aging at Home (AH) national survey for comparative purposes. We developed a logistic regression equation using U.S. data to identify individuals with 3 levels (low, moderate, or high) of predicted 1-year institutional placement risk. Groups with the same characteristics were identified in the Swedish sample and compared on formal and informal assistance received.


RESULTS
Formal service utilization was higher in Swedish sample, whereas informal service use is lower overall. Individuals with characteristics associated with high placement risk received more formal and less informal assistance in Sweden relative to the United States.


CONCLUSIONS
Differences suggest formal services supplement informal support in the United States and that formal and informal services are complementary in Sweden.
Davey
Adam
A
Polisher Research Institute, Abramson Center for Jewish Life, North Wales, PA 19454-1320, USA. ADavey@abramsoncenter.org
Femia
Elia E
EE
Zarit
Steven H
SH
Shea
Dennis G
DG
Sundström
Gerdt
G
Berg
Stig
S
Smyer
Michael A
MA
Savla
Jyoti
J
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006299:Health Services for the Aged / Q000458:organization & administration / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006701:Home Nursing / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D040841:Resource Allocation; D012306:Risk; D013548:Sweden; D014481:United States