van Linschoten C P, Wolffensperger E W
Noordelijk Centrum voor Gezondheidsvraagstukken, Rijksuniversiteit Groningen.
Tijdschr Gerontol Geriatr. 1992 Oct;23(5):171-8.
Results are presented of a 'demonstration project' in care for the elderly in the region South-East Groningen. Three issues were at stake in this project: extension of home-care, interventions in the referral processes to nursing homes and homes for the aged and coordinated allocation and planning of services for the elderly. Effects of the intervention were assessed with a quasi-experimental control-group design. In this paper, the issue of substitution is addressed from two different angles. First, changes in utilization of services in the experimental period (1988-1990) were evaluated. Second, changes in disability of elderly clients were evaluated. In both analyses, controls for national developments took place. The analyses show that substitution occurred, both in terms of utilization of care (more home-care, less institutional care) and in terms of the levels of need of clients (increases in mean level of disability in the populations of home-care and homes for the aged).
本文呈现了格罗宁根东南部地区一个老年护理“示范项目”的结果。该项目涉及三个关键问题：扩大居家护理、干预转诊至养老院和老年之家的流程以及协调老年人服务的分配与规划。采用准实验对照组设计评估干预效果。本文从两个不同角度探讨替代问题。首先，评估了实验期（1988 - 1990年）服务利用情况的变化。其次，评估了老年客户残疾状况的变化。在这两项分析中，均对全国发展情况进行了对照。分析表明，在护理利用方面（更多居家护理，更少机构护理）以及客户需求水平方面（居家护理和老年之家人群的平均残疾水平增加）都发生了替代现象。
