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…

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…

Examined clinical and social-structural factors contributing to hospitalization of nursing home residents. Using participant observation and event analysis of acute-illness episodes, concluded that 48.2 percent of nursing home patient (N=215) hospitalizations could have been avoided. Identified insufficient numbers and training of nurses, lack of…

Interviewed 198 nursing home residents and 34 primary nurse caregivers regarding perceptions and preferences of resident participation in health care decisions. Approximately 40 percent of residents reported being told nothing about their medical conditions; another 40 percent reported being told everything. Concordance between residents' and…

Purpose: This study examines whether the relationship between making familial wealth transfers and becoming a Medicaid recipient sheds light on the current debate about Medicaid estate planning, whereby some elders transfer their assets to their families to qualify for Medicaid. Design and Methods: Using the Health and Retirement Study, we tracked…

Savings in hospital reimbursements through use of extended-care facilities to shorten hospital stays for Medicare patients have more than outweighed the costs of the extended-care facilities. (MF)

This report concerns the Health Care Financing Administration's (HCFA) contracting with Utilization and Quality Control Peer Review Organizations (PROs) as a means of monitoring the medical necessity and quality of in-hospital care provided to Medicare beneficiaries. Findings from a HCFA survey of PROs in California, Florida, and Georgia are used…

Surveyed 35 nursing home staff members and found that nurses generally are not knowledgeable about psychiatric symptoms and do not seek out psychiatric intervention for their patients. Suggests that the organizational character of health care delivery in nursing homes makes adequate nursing response to mental illnesses impossible. (JAC)

Data are presented describing expenditures for personal health services in Michigan from 1977 to 1981. The rapid growth in expenditures is illustrated, as well as the rates of growth in expenditures, for major categories of health services. Personal health expenditures are defined as payments for care directly provided to patients: specifically,…

This report from the Select Committee on Aging examines financial, medical, and social issues surrounding terminally ill patients with special emphasis on the elderly terminally ill. The first section discusses topics related to the medical treatment of the terminally ill. Two basic issues are important: the right to have medical treatment and the…

The increasing age of the American population and the current emphasis on cost containment in health care make the 1980s an ideal time for building bridges to span the health care needs of elderly persons in acute care and long-term care. While hospitals often discharge patients to nursing homes as an intermediate step between hospitalization and…

The Nursing Home Research Study is concerned with the quantitative measurement of nursing service in nursing homes. The purpose of the project was to provide data needed to establish a basis for proposing minimal staffing patterns for nursing homes. In an adaptation of the methodology used in a study conducted by the Milwaukee, Wisconsin Health…

A study of nursing homes in Maine was conducted by student researchers during the summer, 1970, under Maine's Regional Medical Program (MRMP). The survey, focusing on staffing patterns and general needs in nursing homes in Maine, was conducted in order to determine ways in which MRMP might assist the nursing homes and the Maine Department of…

Purpose: The purpose of this study is to expand knowledge regarding end-of-life care received in nursing homes through the use of narrative interviews with family members close to the decedents. Design and Methods: We conducted follow-up qualitative interviews with 54 respondents who had participated in an earlier national survey of 1,578…

The ethical primacy of patient involvement in treatment decision-making requires that more attention be paid to assessment of a patient's competency to make treatment decisions. Makes recommendations to increase sensitivity to this issue with significantly impaired elderly nursing home patients and to improve existing decision-making procedures.…