PIH17 Drivers of Service Use, Costs, and Feasibility for a Potential Social IMPACT Bond (SIB) Among Elderly Finns with Assisted Living Services

Introduction: Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the oldest old longitudinally. Methods: Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. Results: Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. Conclusion: Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

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PA4 Delaying Assistance Intensification Among Elderly with Assisted Living Services: Care Costs, Target Group Profile, and IMPACT Estimation for a Potential Social IMPACT Bond (SIB) in Finland

Value in Health ◽

10.1016/j.jval.2020.08.069 ◽

2020 ◽

Vol 23 ◽

pp. S409

Author(s):

E. Soini ◽

R. Metsä ◽

E. Häkkinen ◽

P. Vähäkangas ◽

M. Hammar ◽

...

Keyword(s):

Assisted Living ◽

Social Impact ◽

Target Group ◽

Group Profile ◽

Care Costs

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Supporting Transition from Out of Home Care to Adulthood: Linked Data Is Central to The Compass Social Impact Bond

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1552 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Sharon Williams ◽

Mark Sipthorp ◽

Nicholas Ivkovic ◽

Alexander Inglis

Keyword(s):

Young People ◽

Home Care ◽

Linked Data ◽

Social Impact ◽

Service Use ◽

Outcome Measurement ◽

Service Design ◽

Control Group ◽

Out Of Home Care ◽

Care Leavers

The COMPASS program supports young people to successfully transition from Out of Home Care to adulthood. COMPASS is a social impact bond partnership between Victorian government, not-for-profit organisations and investors. COMPASS uses linked data in every phase from design, to implementation, to outcome measurement. IntroductionStudies demonstrates that young care leavers experience significantly poorer outcomes than their peers. COMPASS is a preventative program progressivelyproviding 200 care leavers with access to housing and individualised support. The Centre for Victorian Data Linkage (CVDL) developed the Victorian Linkage Map (VLM) in 2016, linking 20 plus health and human services datasets with births and deaths data. Linked data provides a critical evidence base for COMPASS. Objectives and ApproachThe presentation describes application of linked data for COMPASS design, implementation and measurement. Linked data cohort analysis of post-care service use of 6000 young people informed the program design. Linked data also provides the basis for a stratification tool to measure the complexity profile of referrals. Health, housing and justice payable outcomes are measured by comparing relative performance of participants with a matched control group using linked data. ResultsImplementation of COMPASS has highlighted the value of linked data in service design and measurement of payable outcomes. It has also highlighted the challenges of using linked data in a real-world environment, including the need for thorough documentation and testing of specifications, calculations and processes. Conclusion / ImplicationsThe use of linked data for COMPASS provides a model for evidence-based service design and tests the use of linked data for robust and sustainable outcome measurement. The lessons from COMPASS are applicable to other social impact bonds and service implementation and outcome measurement more broadly.

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A Typology of Health Services Regulated in U.S. Assisted Living Communities

Innovation in Aging ◽

10.1093/geroni/igab046.2023 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 528-528

Author(s):

Lindsey Smith ◽

Wenhan Zhang ◽

Sheryl Zimmerman ◽

Philip Sloane ◽

Kali Thomas ◽

...

Keyword(s):

Health Service ◽

Health Services ◽

Assisted Living ◽

Service Use ◽

Health Service Use ◽

Case Mix ◽

State Agencies ◽

Black Residents ◽

Health Related ◽

Dual Eligible

Abstract State agencies regulate assisted living (AL) with varying approaches across and within states. The implications of this variation for resident case mix, health service use, and policy, are not well described. We collected health services-relevant AL regulatory requirements for all 50 states and DC and used a mixed-methods approach (thematic analysis; k-means cluster analysis) to identify six types: Housing, Affordable, Hybrid, Hospitality, Healthcare, and Hybrid-Healthcare. We stratified Medicare claims data by regulatory type, identifying variation in resident case mix and health service use. Housing and Affordable clusters have larger proportions of dual-eligible beneficiaries, Black residents, and residents of Affordable had more long-term nursing home use compared to other clusters. Dual-eligible beneficiaries account for 26.6% of Housing cluster residents compared to 8.1% of Hybrid Healthcare cluster residents. We provide other examples and explain the implications in terms of sampling AL for single and multi-state studies, racial disparities, and health-related policies.

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Mental health service use and cost of care for older adults in assisted living facilities: Implications for public policy

The Journal of Behavioral Health Services & Research ◽

10.1007/bf02287836 ◽

2002 ◽

Vol 29 (1) ◽

pp. 91-98 ◽

Cited By ~ 5

Author(s):

Marion Becker ◽

Paul Stiles ◽

Lawrence Schonfeld

Keyword(s):

Mental Health ◽

Older Adults ◽

Public Policy ◽

Mental Health Service ◽

Assisted Living ◽

Service Use ◽

Cost Of Care ◽

Mental Health Service Use ◽

Health Service Use ◽

Assisted Living Facilities

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Tools to Enhance Resident and Family Engagement in Assisted Living Safety: A Scoping Review

Innovation in Aging ◽

10.1093/geroni/igab046.1332 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 345-346

Author(s):

Jennifer Leeman ◽

Marianne Baernholdt ◽

Christine Kistler ◽

Elizabeth Moreton ◽

Terri Ottosen ◽

...

Keyword(s):

Quality Of Life ◽

Scoping Review ◽

Assisted Living ◽

Daily Living ◽

Service Use ◽

Empirical Studies ◽

Family Engagement ◽

Engagement Strategies ◽

Care Health

Abstract This presentation reports the results of a scoping review which identified and evaluated existing engagement strategies, tools, and interventions for their fit with assisted living (AL). Using the PRISMA criteria, we evaluated 54 empirical studies in assisted living/residential care or nursing homes (NH) for how they engaged families and residents, promoted person-centered and/or safety in AL/NH care, and assessed relevant outcomes (safety, experience, service use, satisfaction with care, health behaviors, and quality of life). The strategies, tools, and interventions aimed to improve residents’ activities of daily living, function, and quality of life. Studies also targeted staff and family caregivers to increase knowledge, improve relationships, and decrease caregiving stress. Overall, the studies reported statistically significant changes in resident quality of life, agitation, antipsychotic use, staff knowledge and job satisfaction. Results from this systematic review will inform the development of a testable toolkit to increase engagement and improve safety in AL.

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A Typology of Caregiving Situations and Service Use in Family Carers of Older People in Six European Countries

GeroPsych ◽

10.1024/1662-9647/a000031 ◽

2011 ◽

Vol 24 (1) ◽

pp. 5-18 ◽

Cited By ~ 8

Author(s):

Mirko Di Rosa ◽

Christopher Kofahl ◽

Kevin McKee ◽

Barbara Bień ◽

Giovanni Lamura ◽

...

Keyword(s):

Health Services ◽

Older People ◽

Support Services ◽

Family Caregiving ◽

Service Use ◽

European Countries ◽

Limited Resources ◽

Family Carers ◽

Policy Initiatives ◽

Typology Of Care

This paper presents the EUROFAMCARE study findings, examining a typology of care situations for family carers of older people, and the interplay of carers with social and health services. Despite the complexity of family caregiving situations across Europe, our analyses determined the existence of seven “caregiving situations,” varying on a range of critical indicators. Our study also describes the availability and use of different support services for carers and care receivers, and carers’ preferences for the characteristics of support services. Our findings have relevance for policy initiatives in Europe, where limited resources need to be more equitably distributed and services should be targeted to caregiving situations reflecting the greatest need, and organized to reflect the preferences of family carers.

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Suicide Prevention Through Online Gatekeeping Using Search Advertising Techniques

Crisis ◽

10.1027/0227-5910/a000322 ◽

2015 ◽

Vol 36 (4) ◽

pp. 267-273 ◽

Cited By ~ 8

Author(s):

Hajime Sueki ◽

Jiro Ito

Keyword(s):

Suicidal Ideation ◽

Suicide Prevention ◽

Help Seeking ◽

Service Use ◽

Web Search ◽

Suicide Attempts ◽

Consultation Service ◽

Search Advertising ◽

Internet Users ◽

History Of

Abstract. Background: Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. Aims: A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Method: Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. Results: A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Conclusion: Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.

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