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  • 1.
    Lagergren, Mårten
    et al.
    Stockholm Gerontology Research Center.
    Fagerström, Cecilia
    Blekinge Institute of Technology.
    Sjölund, Britt-Marie
    Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University.
    Berglund, Johan
    Blekinge Institute of Technology.
    Fratiglioni, Laura
    Stockholm Gerontology Research Center; Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University .
    Nordell, Eva
    Division of Geriatric Medicine, Department of Health Sciences, Lund University and Skåne University Hospital.
    von Strauss, Eva
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University.
    Wimo, Anders
    Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet and Stockholm University; Department of Neurobiology, Alzheimérs Disease Research Center, Care Sciencesand Society, Karolinska Institutet.
    Elmståhl, Sölve
    Division of Geriatric Medicine, Department of Health Sciences, Lund University and Skåne University Hospital.
    Horizontal and vertical targeting: a population-based comparison of public eldercare services in urban and rural areas of Sweden.2015Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, nr 1, s. 147-158Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.

  • 2.
    Westerbotn, Margareta
    et al.
    Sophiahemmet högskola / Karolinska institutet / Äldrecentrum.
    Hillerås, Pernilla
    Sophiahemmet högskola / Karolinska institutet / Äldrecentrum.
    Fastbom, Johan
    Karolinska institutet / Äldrecentrum.
    Agüero-Torres, Hedda
    Karolinska institutet / Äldrecentrum.
    Factors influencing the handling of medicines among very old people living at home in an urban area2006Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 18, nr 6, s. 497-502Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aims: Elderly people in Sweden live longer in their own homes, some of them with good health, and others with chronic conditions that require medical treatment. Thus, the aim of this study was to investigate factors influencing elderly people’s handling of their medicines. Methods: Cross-sectional population-based study. Participants were 333, aged 84+ years, living in their own homes. Information on regular drug use was obtained from interviews. Descriptive statistics were used to describe the population, and logistic regression models were used to investigate the factors associated with receiving help in handling medicines. The Mini-Mental State Examination (MMSE) measured cognitive status, and the basic Activities of Daily Living (ADL) assessed functional status. Results: Most participants were women living alone. 88% of this population took medicines on a regular basis and 23% of them received help with medicine handling. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female (OR=2.8, 95% CI=1.2–6.5) was the only variable associated with regular use of medicines. Older age and functional disability in ADL increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. The only factor related to receiving help from a family member was living alone (OR=0.05; 95% CI=0.01–0.40). Conclusions: This study indicates that cognitive and functional problems require increased help with handling medicines. These results stress the need for ongoing vigilance of, and support for, people with this high-risk profile.

  • 3.
    Westerbotn, Margareta
    et al.
    Sophiahemmet högskola / Karolinska Institutet / Äldrecentrum.
    Hillerås, Pernilla
    Sophiahemmet högskola / Karolinska Institutet / Äldrecentrum.
    Fastbom, Johan
    Karolinska Institutet / Äldrecentrum.
    Agüero-Torres, Hedda
    Karolinska Institutet / Äldrecentrum.
    Pain reporting by very old Swedish community dwellers: the role of cognition and function2008Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, nr 1, s. 40-46Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aims: Pain is a common and unpleasant problem among elderly people and affects the possibility for them to remain living in their own homes. The aims of this study were therefore to report the prevalence of pain reporting and pain treatment, and their association with functional and cognitive status in a very old population. Methods: Cross-sectional population-based study. Participants were 333, aged 84 years or older, living at home alone or with someone in Kungsholmen, in central Stockholm, Sweden. Information on pain was obtained from interviews. The Mini-Mental State Examination (MMSE) measured cognitive status and the index of basic Activities of Daily Living (ADL) functional status. Descriptive statistics were used to describe the population and logistic regression models to investigate factors associated with pain reporting and pain treatment. Results: The prevalence of pain was 46%, and the prevalence of pain treatment 71%. Results from logistic regression analysis including all variables in the model showed that pain reporting was not associated with age, gender or living conditions. However, pain reporting was correlated with cognitive and functional status. There was no association between pain treatment and age, gender, living conditions, cognitive or functional status. Conclusions: Pain is common among the oldest old. Our results indicate that cognitive and functional status affect pain reporting. Poor cognitive status was associated with less pain reporting, whereas poor functional status was associated with more pain reporting.

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