Pathways into and through services for the elderly in Europe: a research design.

Services for the elderly fall short of demand in all European countries. Resources are clearly inadequate. But are they most effectively used? This contribution presents the research design being used to study these questions in eight countries of the European Community. It postulates that shortage of shortage of services is aggravated by fragmentation between organisations and professions, by associated inflexibility in planning, transfer of resources and adaptation to changing needs, and by over-concentration of resources and influence upon medical and residential institutions. The study involves the observation of cohorts of patients/clients entering and passing through the health and social services and the relationship between this experience and the expectations of the clients, their relatives and their service providers. The key question is how far structural features of each health and social service system facilitate or hinder the effective delivery of care. Methodological problems of cross-national research are discussed.