Variation in long-term care needs assessors' willingness to support clients' requests for admission to a residential home: a vignette study.
OBJECTIVE
The purpose of this study is to determine what client, needs assessor, and agency factors explain variation in decision making by long-term care needs assessors concerning clients requesting admission to a residential home.


METHODS
Hypothetical case vignettes were sent to needs assessors allocating services for the elderly. Multilevel logistic regression analysis provided random and fixed effects.


RESULTS
The authors found random effects of the level of needs assessors are negligible, of the level of agencies small though statistically significant, clients receiving largest relative share of the variance. The amount of care already present appeared most important in the decision. Needs assessors were willing to support their clients' wishes only when they were clearly motivated. Policy implications considering the tension between clients' preferences and equity are discussed.
Jörg
Frederike
F
GG2 Friesland, PO Box 932, 8901 BS Leeuwarden, the Netherlands. frederike.jorg@gg2friesland.nl
Borgers
Natacha
N
Schrijvers
Augustinus J P
AJ
Hox
Joop J
JJ
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004608:Eligibility Determination / Q000379:methods*; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008134:Long-Term Care; D008297:Male; D020380:Needs Assessment; D009426:Netherlands; D010343:Patient Admission / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012112:Residential Facilities; D012737:Sex Factors