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Reforming Foodservice in Elderly Care: National Actions and Local Outcomes
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.ORCID iD: 0000-0002-5423-4262
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Statistics.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
2017 (English)In: Nutrition & Dietetics, ISSN 1446-6368, E-ISSN 1747-0080Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: The aim was to explore the outcome, on a local level, of steering, organisation and practices of elderly care foodservice by Swedish municipalities, and changes relative to national actions.

Methods: A survey using a web-based questionnaire about elderly care foodservice targeting all Swedish municipalities (n=290) was conducted in 2006 and 2013/14. The questionnaire included the topics: organisation of foodservice, its practice in elderly care, and steering devices such as guidelines and policies. Based on the share of a rural population, municipalities were divided into groups: rural (≥50%), urban (<50%) and city (≤20%).

Results: The response rate from municipalities was 80% in 2006 and 56% in 2013/14; 45% participated in both surveys. The results showed increased use of local food policies (P=0.03) and meal choice (P<0.001), while access to clinical/community dietitians declined (P=0.01) between the surveys. In home-help services, daily delivered cook-serve meals declined (P<0.001) and chilled meals delivered three times a week increased (P=0.002) between the surveys. City municipalities used private foodservice organisations the most, (P<0.001) and reported reduced use of cook-serve systems in favour of chilled. In rural municipalities, the use of public providers (98%) and a cook-serve system (94%) were firmly established. Urban municipalities were placed between the other groups.

Conclusions: National actions such as soft governance and benchmarking appear largely to determine local level outcomes. However, conditions for adapting these measures vary between municipality groups. While efficiency enhancing trends were prominent, questions remain whether national actions should be expanded beyond performance to also examine their consequences.

Place, publisher, year, edition, pages
2017.
Keyword [en]
dietitians, food policy, food services, health services for the elderly, surveys and questionnaires
National Category
Social Sciences
Research subject
Food, Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-330116DOI: 10.1111/1747-0080.12388OAI: oai:DiVA.org:uu-330116DiVA: diva2:1144321
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2017-11-03

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Skinnars Josefsson, MalinNydahl, MargarethaMattsson Sydner, Ylva
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