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Public policy and residential provision for the elderly
Institution:1. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London;2. Institute of Cancer Policy, King’s College London, London, UK;3. Division of Oncology, Columbia University, New York, USA;4. School of Social and Community Medicine, University of Bristol, Bristol;5. Department of Global Health and Social Medicine, King’s College London, London, UK
Abstract:In recent years there has been a growing concern about the best type of residential care for the increasing elderly population in Britain. This paper examines the response of the public, private and voluntary sectors to the provision of residential care. It looks at the relative levels, spatial variations in the levels and changes in the proportions of provision by each of these sectors for the years 1981 and 1984. The levels of provision are related to indices of need, available resources and the political disposition of each local authority area. This paper then focuses on the variations in the growth of the private-sector provision of residential homes. It was found that the metropolitan districts had the greatest proportion of voluntary-sector provision; and the traditional seaside retirement counties such as Devon and Lancashire had the highest levels of and experienced the greatest growth in private residential care. The key variables in explaining variations in the mix of provision between areas were indices of need and resources. This study has established that there are great regional variations in the mix of the different sectors of residential care, although it is not possible to offer a total explanation of these differentials. In Britain, there are substantial inequalities in terms of the choice of types of provision for the elderly population which have significant implications for local authority policy.
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