Purpose: We compared inpatient days, nursing home days, and total Medicaid claims for five Medicaid-funded home- and community-based services (HCBS) programs for in-home and assisted living services in Florida. Design and Methods: We studied a single cohort of Medicaid enrollees in Florida aged 60 and older, who were enrolled for the first time in…

Analyzed health care use in four years prior to death for 4,256 elderly decedents. Found hospital bed use by nursing home residents declined with age and was much lower than for decedents in community. Institutionalized elders were much less likely to die in hospitals than were community elders, particularly very old and longer-term patients.…

Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

Assessed service utilization and cost impacts of a consolidated model of long-term care for functionally impaired elders. Compared to traditional long-term care, this model reduces hospital and nursing home stays, redistributes funds to broad range of community-based services, and reduces overall cost of long-term care. (Author/NRB)

Examined health service utilization by 4,800 Canadian elderly. Findings suggested that most elderly are healthy and are infrequent users of services. Identifies a minority of very high users of health care and discusses the potential influence of physicians on health care use by the elderly. (JAC)

Describes a holistic health care program (Personal Health Management System) initiated within several retirement communities. Initial findings suggested that program participants experienced significant increases in their health and well-being while nonequivalent control group subjects did not. Conceptual and methodological issues are discussed.…

Studies community services in long-term care used by older minority adults and concludes that the extent to which minority older persons are receiving a proportionate share of services is not consistent across targeted minority populations. The strongest predictors of older minority persons served are staffing patterns and location. (Author)

Improvements in the care of older people depend upon basic and clinical research findings that lead to greater independence and health maintenance. Conversely, research depends upon care, since care-related priorities influence society's support for research. More leaders in the field of aging are needed with personal experience in both care and…

Two hospitals have conducted semiannual Town Meeting for Seniors to provide community-based health education, helping seniors make informed decisions about medical care, Medigap insurance, advance directives, and proper nutrition. Town Meeting has been enthusiastically received by consumers and has led to creation of several new community…

Used secondary data sources to examine relative importance of geographic mobility as factor affecting use of Veterans Administration (VA) health services by older veterans. Found that variation in state VA health service admission rates was better explained primarily by characteristics of resident nonmobile veteran population and characteristics…

Many studies examining health service utilization by older adults involve secondary analyses of existing data sources and rely on behavioral model of health services utilization. Suggests that severe shortcomings in breadth and depth of available data, and numbers of intervals at which data have been recorded, limit understanding of health…

Purpose: States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care. A substantially greater share of long-term-care dollars supports community-based care for individuals with intellectual and developmental disabilities, relative to older and working-age persons with primarily physical disabilities.…

Purpose: Family caregivers comprise the backbone of long-term-care provision in the United States, yet little is known about how the composition and experience of family caregiving has changed over time. Design and Methods: Data are drawn from the 1989 and 1999 National Long-Term Care Survey and Informal Caregiver Survey to develop nationally…

Purpose: We estimate the independent contribution of crime victimization to nursing home placement in a cohort of older adults who were community dwelling at baseline. Design and Methods: The data come from an observational cohort study of 2,321 community-residing older adults who were members of the New Haven Established Populations for…

Compared first- and second-generation interorganizational service system serving the elderly. Found that integration of Medicaid programs with Administration on Aging-funded system was changing structure of community-based elderly services. Second-generation system served larger volume of clients, being more centralized, differentiated,…