Ageing and Society

Research Article

How equitable is Sweden's changing care-mix? Linking individual and regional characteristics over time

ADAM DAVEYa1 c1, JYOTI SAVLAa2, GERDT SUNDSTRÖMa3, STEVEN H. ZARITa2 and BO MALMBERGa3

a1 College of Health Professions, Temple University, Philadelphia, USA.

a2 Human Development and Family Studies, Pennsylvania State University, USA.

a3 Institute of Gerontology, Jönköping University, Sweden.

ABSTRACT

Given its relative ethnic and socio-economic homogeneity, Sweden is an ideal nation for the study of variations in formal and informal care as a function of gender, disability and advanced age. This paper reports an analysis of the relationships between gender, disability and age and the formal care delivered to more than 1,200 people aged 75 or more years in Sweden in 1994 and 2000. In municipalities that provided above-average home-help hours per recipient, and that had high institutional placement rates, women were relatively less likely to have been receiving informal assistance alone, those with greater disability were more likely to have been receiving all forms of assistance, the oldest-old were less likely to have been receiving either informal or formal help alone, and rates of formal assistance and of no informal care were relatively low. In municipalities with high rates of institutional placement, the oldest-old were relatively more likely to have been receiving both formal and informal assistance. Sweden's system of old-age care appears broadly equitable although the quality of care could not be fully assessed. Although home and community-based service provision (HCBS) has recently decreased, variations in the volume and mix of delivered formal services reflect differences in need.

(Accepted November 12 2006)

Correspondence:

c1 Address for correspondence: Adam Davey, College of Health Professions, 1700 N. Broad Street, Suite 313, Temple University, Philadelphia, PA 19122, USA. E-mail: adavey@temple.edu