ABSTRACT
It has been argued that the potential substitutability of service inputs is one of the defining characteristics of community and long-term care compared with
many acute interventions. The question has always been whether this substitution potential has been realised in managing service content and mix (Da vies, 1995; Da vies and Challis, 1986). As predicted from that theory, our evidence suggests a very high degree of substitutability between services. For instance, that many care packages for persons of quite different circumstances consist of only one service suggests that allocators believe that each can produce a variety of outputs. The questions are (a) what range and levels of outputs can be produced from a single service as well as (b) what combinations can be produced from what input mixes. The former question is interesting because having fewer workers with wider spans of output goals from a single service offers potential benefits as well as potential economies.
