Background: The health sector faces major challenges as a consequence of the elderly constituting a growing proportion of the population. Doctors at all levels will need to acquire the skills needed for dealing with patients with multiple and complex conditions, and hospitals will need to be dynamic in dealing with patients with acute and curable diseases as well as with the elderly and chronically ill. There is a considerable professional gap between community care services and services offered by the general hospitals.
Material and methods: In the City of Trondheim, Norway, the community care and hospital services have analysed the challenges they share and what they can do to make the "chain of care" better for those patients that are the most in need of coordinated efforts. One initiative is two short-term units specialising in treatment and care at an intermediary level between ordinary nursing homes and hospitals.
Results: In 2003, 275 patients were admitted to the intermediary care department in Søbstad nursing home, and at Havstein nursing home 79 patients were admitted to its palliative care department. The operating costs in these nursing homes are higher than in traditional units, but far lower than in hospitals. We suggest that these specialised units represent a good solution, professionally as well as financially.