Author: Pande Archana Laditka Sarah B. Laditka James N. Davis Dorothy
Publisher: Haworth Press
ISSN: 0162-1424
Source: Home Health Care Services Quarterly, Vol.26, Iss.3, 2007-07, pp. : 39-60
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
Abstract
Long-term care will increasingly shift from institutions to home and community based services. Using data from a Medicaid home care waiver program in South Carolina, the Community Long-Term Care (CLTC) program, we evaluated differences in frailty and service use among CLTC clients between 1995 (n = 3,748) and 2005 (n = 9,157). The expectation was that CLTC clients had become more frail in that period, and had greater access to services in the community, results that might suggest the CLTC program had helped individuals to avoid institutionalization. Frailty measures included acute and chronic conditions, other health conditions, and activities of daily living (ADL). We evaluated the percentage of clients using services, and service use intensity. A large majority of clients in both years were impaired in at least four ADL. In 2005, CLTC clients were significantly more likely to have chronic conditions, including hypertension, chronic obstructive pulmonary disease, Alzheimer's disease, arthritis, diabetes, and renal failure (all p < 0.05). Clients were significantly more likely to receive specific services in 2005, including physical therapy, dialysis, and oxygen (all p < 0.05). Results suggest CLTC participants were more frail in 2005 than in 1995. This may reflect a successful effort to help individuals age in place in the community, delaying institutionalization. States may be able to control increases in Medicaid long-term care costs through home care programs that delay institutionalization. doi:10.1300/J027v26n03_03
Related content
By Rabiner Donna J Scheffler Scott Koetse Elizabeth Palermo Jennifer Ponzi Elizabeth Burt Sandra Hampton Lynelle
Home Health Care Services Quarterly, Vol. 22, Iss. 4, 2004-02 ,pp. :