2014 Conference Presentation
Data and methods: Before and after study design is used. The baseline study collection was conducted in May-June 2013 and these results will be presented. Data was collected with structured questionnaires using webropol system from the municipalities responsible for providing services to their population (n=208), response rate 100%; from public and private providers of long-term care in institutions (n=1842) and home care (n=641). The client coverage in long-term and home care was about 90%. For monitoring staffing ratios both planned and factual, a one week follow-up of staff was conducted in each unit. In addition, national care and population registers were used to calculate age adjusted care use.
Results: Age adjusted rates of coverage indicate that long-term institutional services have decreased during last decade, as well as home care and support services. The use of services is accumulating in older age groups, especially among women. The only increasing type of service is statutory informal care. Our results indicate that the municipalities, with new requirements by the Act, were quite well prepared: 60% of municipalities already had the planning and follow-up for ensuring the wellbeing of aged population in action. There still remained challenges for follow-up system for assessing service needs and risk groups. A systematic and comprehensive assessment, as the law requires, was in use in 40% of providers. The staffing ratios lower than 0.50 were found in fifth of the providers, mainly on service housing. In long-term care units, the relationship between staffing levels and quality of care was multifactorial, and no direct correlation could be found. The baseline results from service providers show that possibilities for 24/7 care in community-based services were not yet given in all areas of Finland.
Policy implications: The new Act aims for community based care. Age-age adjusted trends indicate that deinstitutionalization has already been in progress since beginning of 2000. The follow-up survey in fall 2014 will indicate which actions have been taken in municipalities and among service providers. This kind of information will be usable for supervisions officials to act on, and on overall showing how the implementation proceeds in Finland.