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(Profile of disability in elderly people: estimates from a longitudinal population study)

Better integration between acute and long term care for elderly patients is needed, say researchers in this week's BMJ. Their claim is based on an analysis of the Medical Research Council's cognitive function and ageing study. They found that disabled elderly people both use acute hospitals extensively and a large proportion of them live outside institutions, depending on formal and informal care givers.

In their analysis of 10,377 people in Cambridgeshire, Newcastle, Nottingham and Oxford, Dr David Melzer and colleagues found that eleven per cent of men and 19 per cent of women aged 65 years and over were disabled, totalling 1.3 million people in the UK. Overall they discovered that more than 80 per cent of elderly disabled people needed help on at least a daily basis and that 63 per cent used acute hospital services over a two year period.

The authors write that throughout the developed world the funding of care for disabled elderly people has become a highly publicised political issue. They say that according to previously published figures, UK total expenditure on long term care is estimated to account for 3.6 per cent of gross domestic product and that this figure could rise to 10.8 per cent by the year 2030.

Melzer et al conclude that there is considerable overlap between acute hospital and long term care and that there is a strong case for improved co-operation between the two. They say that there should be incentives for the provision of services aimed at preventing the need for hospital admission as well as improvement in arrangements for early discharge and rehabilitation in the community.

Contact:

Dr David Melzer, Clinical Senior Research Associate, Department of Community Medicine, University of Cambridge, Institute of Public Health, Cambridge dm214@medschl.cam.ac.uk

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Contact: Jill Shepherd
jshepherd@bma.org.uk
44-171-383-6529
BMJ-British Medical Journal
23-Apr-1999