Early intervention in long-term care: new model for tailored initial efforts and allocating of services (EARLY INTERVENTION)

THE GATEWAY TO AND ALLOCATION OF LONG-TERM CARE SERVICES Increasing numbers of older and younger people in need of assistance are creating strong pressure on local care services. The applications come directly from those who apply for assistance, or via relatives, GPs or hospitals. They are then assessed by the municipality's allocation office before a decision is made on approval or refusal. Some municipalities have tried out new models with their own interdisciplinary assessment teams with early intervention before decisions are made. In this project, we will compare the traditional and the new ways of proceeding to assess the need and allocate services. We will do research on the financial consequences for the municipalities, the consequences for the applicants and their relatives and the consequences for the employees. In addition, we will compare the models for the assessment and allocation of services in the Nordic countries. Are some service delivery models more promising than others? The project is therefore about the gateway to the large care services in the municipalities, about the early interventions and efforts and about models for allocation of services. The entrance gate constitutes a particularly important and critical phase both for the users and the municipalities. This phase has not been much studied. Researchers at HVL, NORCE, NTNU, FHI, VID, Roskilde University, Umeå University and University of Jyväskylä participate. Bergen, Askøy, Kvam and Oslo municipalities collaborate on the implementation of the research. Other important partners are KS, the USHTs in Oslo and Hordaland, the councils for the elderly in Oslo and Bergen, as well as the Council for Persons with Disabilities in Oslo. The aim is to gain more knowledge about the entrance gate, and that this can benefit the users and the municipalities.

The EARLY INTERVENTION project will generate new knowledge regarding access to and allocation of long-term care (LTC) services, a significant and comprehensive part of health and care services, where 1/3 of the municipal costs are spent (Statistics Norway, 2023). This gateway is an understudied yet crucial phase both for the LTC applicants and the service providers, with consequences for the applicant's future quality of life, scope of service use and municipal costs. Ageing is a major public health challenge and the demand for LTC services steadily increases along with the costs of service provision. In response, some municipalities have changed their procedures for initial follow-up and evaluation of the needs of new applicants. While the traditional model of assessing incoming applications is characterised by formal case management and rapid decision-making at a distance, the new emerging model assesses and intensively follow up on new applicants by interdisciplinary teams up to four weeks before making a decision. Through continuing cooperation with municipalities and a multi-actor, mixed-method and interdisciplinary approach, we will explore experiences and examine short-term as well as long-term outcomes of such early intervention practices in home-based long-term care services: WP 1: Effects on individual service use and costs to society WP 2: Health and welfare effects for applicants and their family WP 3: Consequences on service provision and at employee level WP 4: Models of early interventions in Nordic countries The EARLY INTERVENTION project is developed in collaboration between four municipalities, three user groups organisations and seven research institutions. Through this collaboration, we aim to contribute to knowledge-building at the municipal level and to research-based policy that may enhance tailored and sustainable LTC services.