Integrated care of older people: Lessons from intervention projects in Sweden

Background: Care of older people in Sweden has undergone substantial cutbacks in institutional care, not being compensated for by a corresponding increase in the provision of home based care. Frail older people with complex health problems therefor have to seek hospital care, often as a result of a breakdown in home care provision. In 2010, national government financial incentives to stimulate new, innovative care models to address problems with providing coordinated services and care to very frail older people living at home. Aims: To carry out a scientific evaluation of local intervention projects. Methods: The evaluation is descriptive, based on primary and secondary data. Project plans, data and results from local evaluations, interviews, and site-visits were collected and analysed. Results: Preliminary results show that only a minority of the projects could provide the data necessary for a scientific evaluation, due to poor targeting, lack of base-line data, poor description of the interventions and also insufficient evaluation knowledge/experience. However, a few projects report interesting and valid results in terms of increased quality of life, longevity and less use of e.g. hospital care. Conclusions: Crucial factors for success seem to be well-defined target group and high quality of the intervention.