Horizontal and vertical target efficiency - a comparison between users and non-users of public long-term care in Sweden

Marten Lagergren, Britt-Marie Sjolund, Cecilia Fagerstrom, Johan Berglund, Laura Fratiglioni, Eva Nordell, Anders Wimo, Sölve Elmståhl

Research output: Contribution to journalArticlepeer-review

8 Citations (SciVal)


The extent to which a system of services is in tune with the needs of the population can be expressed in terms of target efficiency, which includes horizontal target efficiency - the extent to which those deemed to need a service receive it - and vertical target efficiency - the corresponding extent to which those who receive a service actually need it. Vertical efficiency can be measured by looking only at those receiving services. To measure horizontal target efficiency in a population, one must have access to population surveys. Data were taken from the baseline survey of the Swedish National Study on Ageing and Care (SNAC study). The results show that more than 80 per cent of those dependent in personal activities of daily living in the studied geographic areas were users of public long-term care (LTC). Dependency in instrumental activities of daily living was identified as the most important predictor of using LTC. Vertical target efficiency was 83-95 per cent depending on age, gender and type of household, if need was defined as dependency in instrumental activities of daily living. It was considerably lower, 35-61 per cent when defined as dependency in personal daily activities. Overall, long-term target efficiency in Sweden must be regarded as high. Few persons who need public LTC services fail to receive them.
Original languageEnglish
Pages (from-to)700-719
JournalAgeing & Society
Issue number4
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Gerontology, specializing in Medical and Health Sciences


  • long-term care
  • public
  • population survey
  • target efficiency
  • older
  • people


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