[Substitution effects in the care for the elderly in Southeast Groningen]

Results are presented of a 'demonstration project' in care for the elderly in the region South-East Groningen. Three issues were at stake in this project: extension of home-care, interventions in the referral processes to nursing homes and homes for the aged and coordinated allocation and planning of services for the elderly. Effects of the intervention were assessed with a quasi-experimental control-group design. In this paper, the issue of substitution is addressed from two different angles. First, changes in utilization of services in the experimental period (1988-1990) were evaluated. Second, changes in disability of elderly clients were evaluated. In both analyses, controls for national developments took place. The analyses show that substitution occurred, both in terms of utilization of care (more home-care, less institutional care) and in terms of the levels of need of clients (increases in mean level of disability in the populations of home-care and homes for the aged).