[Blockage of health care pathways]

The social welfare policy, adopted in the 1970s, of devising ways to help the aged to remain in their homes and adapting institutions to the problems of the very old was instituted without being integrated into the incentive programs of such other sectors as public health and housing. The result has been a patchwork of services and centers whose organization, financing, and allowances are fragmented among a multitude of agencies. In addition, there is an imbalance of resources among the different sectors providing medical care and social welfare assistance. This makes for substantial difficulties in coordinating the activities of service providers and in financing some of the services. Moreover, inflexibility is apparent in adjusting types of services to varied and evolving needs. These problems explain the gaps, disjointed character of care, and faulty guidance in the system of distributing assistance that constitute so many blockages of the pathways used by the elderly. Such blockages cannot be usefully examined by analyzing the overall system, but must be studied at local points of convergence among clients, services and institutions. Such research is presently being conducted by the Concerted Action Committee of the European Community's Health Service Research.