Purpose: Little is known about mental health disorders (MHDs) and their associated health care expenditures for the dual eligible elders across long-term care (LTC) settings. We estimated the 12-month diagnosed prevalence of MHDs among dual eligible older adults in LTC and non-LTC settings and calculated the average incremental effect of MHDs on…

Purpose: To demonstrate the feasibility of the BRIGHTEN Program (Bridging Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking), an interdisciplinary team intervention for assessing and treating older adults for depression in outpatient primary and specialty medical clinics. The BRIGHTEN team collaborates "virtually"…

Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated…

Purpose: Although caregivers desire specific information about hospice programs, there is little descriptive information available. We characterized agencies that provide formal or informal hospice care in the United States according to four types of services considered important by caregivers: medications and treatments; rehabilitative care;…

Purpose: We identified the types of home-and community-based services (HCBS) that high-risk older adults in Medicare managed care used, and we examined participant characteristics associated with service use in six areas: overall service use, four specific categories of HCBS, and referrals to insured medical services. Design and Methods: We used…

Evaluated Connecticut's Medicaid Home and Community-Based Care program which allowed elderly persons to remain in community with home and community-based services instead of entering nursing homes. Results did not reveal if the program was cost effective. Recommends rigorous preadmission screening of nursing home applicants to increase likelihood…

Purpose: The purpose of this article is to explore how medical care is delivered to older people in assisted living (AL) settings and to suggest ways for improving it. Design and Methods: We present a review of the limited research available on health care for older AL residents and on building testable models of better ways to organize primary…

Purpose: This study analyzed the effect of consumer-directed versus agency-directed home care on satisfaction with paid personal assistance services among Medicaid beneficiaries in Washington State. Design and Methods: The study analyzed a survey of 513 Medicaid beneficiaries receiving home- and community-based services. As part of a larger study,…

Notes that health maintenance organizations (HMOs) provide large volume of health care services to older Americans. Contends that HMOs must reexamine general practice of equating utilization of services with health care need and collect better population-based information, including measures of health status. Discusses data elements widely…

Reports that the elderly appear most influenced in health attitudes and behaviors by various factors within the setting so those who identify a major source of care tend to be higher utilizers, do less "shopping-around," and exhibit less negative behaviors such as needing care without seeking it. Discussion of the article follows. (Author)

Conducted national survey of public opinion on age-based rationing of health care resources. Oversampled older adults to allow more precise comparisons of attitude by age cohort as well as by other demographic variables. Found majority of people accepted withholding of life-prolonging medical care to hopelessly ill patients, but few would…

Purpose: To promote health and maintain independence, Just for Us provides financially sustainable, in-home, integrated care to medically fragile, low-income seniors and disabled adults living in subsidized housing. Design and Methods: The program provides primary care, care management, and mental health services delivered in patient's homes by a…

Purpose: We estimated the effect of a voucher benefit on the demand for personal assistance by Medicare beneficiaries aged 65 years or older who had functional disabilities. Design and Methods: We performed a secondary data analysis on 645 Medicare beneficiaries from the Medicare Primary and Consumer-Directed Care Demonstration (a randomized…