Academic journal article Health Care Financing Review

Expenditures for Long-Term Care Services by Community Elders

Academic journal article Health Care Financing Review

Expenditures for Long-Term Care Services by Community Elders

Article excerpt

Costs of care are presented for elderly persons in five community-based settings. These settings include elderly persons living in their own homes or in group housing and who do or do not receive case-managed home care. Expenditures for care ranged from a lo w of about 1, 1 00 per year to a high of $4,025. The level of expenditure was directly related to risk of institutionalization and was higher for those receiving case-managed home care. As a majority of the elderly use a substantial amount of care even without case management, the potential for community care demonstration programs to yield significant cost savings appears quite limited. Introduction

The aging of the U.S. population is forcing social and health planners to attempt to develop service packages that will be increasingly needed by the frail elderly. A consensus has emerged in the gerontology community, motivated by both quality of life and cost considerations, that individuals should be maintained in a community setting for as long as possible. Early efforts at promoting community living through the provision of regular home care or case-managed home care have not yielded the anticipated reduction of institutional use that was the implicit or explicit expectation underlying many of these demonstrations (Weissert, 1985; Kemper, Applebaum, and Harrigan, 1987). We now recognize that home care alone cannot be the base upon which new long-term care delivery systems are developed.

An obvious, but partially neglected, base for new long-term care programming is housing (Congressional Budget Office, 1977; Beland, 1984; Rice and Estes, 1984; Newman, 1985). This crucial program element, either with or without a case-managed home care add-on, may provide the key to maintaining community residency. An important element in developing housing-based models is knowledge of service use patterns by a cross-section of the elderly in various housing/care arrangements. Some of the necessary data in this area are provided in this article. We present annual expenditure estimates for both institutional and community-based social services used by elderly persons in five actual community settings. These settings are:

Elderly persons living in their own homes or

apartments and not receiving case-managed home

care.

Elderly persons living in their own homes or

apartments and receiving case-managed home care.

Individuals living in publicly or privately sponsored

housing for the elderly and not receiving case-managed

home care.

Individuals living in publicly or privately sponsored

housing for the elderly and receiving case-managed

home care.

Elderly persons living in publicly or privately

sponsored, service-enriched congregate housing,

where meals and other social services are provided

under the building's auspices. Methods The study sample

Four longitudinal data sets drawn from studies conducted by the Department of Social Gerontological Research, Hebrew Rehabilitation Center For Aged, were used to generate the five study cohorts. These data sets and the time periods during which they were collected are:

A stratified random sample of individuals 62 years

of age or over, living in Massachusetts in a

community setting during the baseline time period

(1982-83).

A stratified random sample of elderly clients served

by Massachusetts Home Care Corporations, which

was providing State-financed, case-managed home

care (1982-83). 9 Experimental and control participants in the

National Congregate Housing Services Program

evaluation, representing sites across 14 States'

(1980-84). e- Senior center clients from the State of Delaware

(1979-81).

The study cohorts assembled from these data sets represent a broad range of the elderly living either in their own homes and apartments or in some type of group housing. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.