Community care for the elderly in Lombardy : needs, resources and outcomes
The thesis discusses the provision of community care for the elderly in Lombardy, a region of Northern Italy. The main part consists in an original analysis of the quantitative data gathered there, focusing on issues concerning services' utilisation, outcomes and costs. The thesis is conducted using several tools and logics of the "Production of Welfare" approach, developed at the Personal Social Services Research Unit (PSSRU) since the '70s and used in a number of studies. It deals with three topics. The first topic concerns services' utilisation: the process through which care resources are allocated, their comparison with users and carers' needs and the geographical differentiations. The second topic regards outcomes: the aim is to highlight the connections between inputs and outcomes (concerning hospitalisation, impact on users' health and on the dependency and other domains) and to understand the impact of the former on the latter. The third topic concerns costs: the thesis analyses different kind of costs (direct, indirect and intangible) borne by different stakeholders involved (users in different conditions, informal carers, public services and private professionals). The thesis is divided into two parts. The first part discusses the policy towards the frail elderly in Italy and Lombardy and the debate on it; it then illustrates the methodology used in the empirical part of the work. The first part provides the background for the second one, concerning the original research findings. The latter, after presenting the research design, examines the overall context of community care in Lombardy and then focus on three major themes: the utilisation of the services, their outcomes and their costs.