scholarly journals Integrated Home‐ and Community‐Based Services Improve Community Survival Among Independence at Home Medicare Beneficiaries Without Increasing Medicaid Costs

2019 ◽  
Vol 67 (7) ◽  
pp. 1495-1501 ◽  
Author(s):  
Girish Valluru ◽  
Jean Yudin ◽  
Christine L. Patterson ◽  
Joanna Kubisiak ◽  
Peter Boling ◽  
...  
2011 ◽  
Vol 52 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Masafumi Kuzuya ◽  
Jun Hasegawa ◽  
Yoshihisa Hirakawa ◽  
Hiromi Enoki ◽  
Sachiko Izawa ◽  
...  

2009 ◽  
Vol 47 (2) ◽  
pp. 63-83 ◽  
Author(s):  
Roger J. Stancliffe ◽  
K. Charlie Lakin ◽  
Sarah Taub ◽  
Giuseppina Chiri ◽  
Soo-yong Byun

Abstract Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's neighborhood, feeling happy, feeling that staff are nice and polite, and liking one's home and work/day program. Loneliness was the most widespread problem, and there were also small percentages of people who reported negative views in other areas. Few differences were evident by HCBS and ICF/MR status. The findings document consistent benefits of residential support provided in very small settings—with choices of where and with whom to live—and to individuals living with family.


2019 ◽  
Vol 23 (1) ◽  
pp. 33-39
Author(s):  
Bo Hye Lee ◽  
Hae Kook Lee ◽  
Keun-Ho Joe ◽  
Sulki Chung ◽  
Hong Seok Oh ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041569
Author(s):  
Lucina Rolewicz ◽  
Eilís Keeble ◽  
Charlotte Paddison ◽  
Sarah Scobie

ObjectivesTo investigate individual, practice and area level variation in patient-reported unmet need among those with long-term conditions, in the context of general practice (GP) appointments and support from community-based services in England.DesignCross-sectional study using data from 199 150 survey responses.SettingPrimary care and community-based services.ParticipantsRespondents to the 2018 English General Practice Patient Survey with at least one long-term condition.Primary and secondary outcome measuresThe primary outcomes were the levels of unmet need in GP and local services among patients with multiple long-term conditions. Secondary outcomes were the proportion of variation explained by practice and area-level factors.ResultsThere was no relationship between needs being fully met in patients’ last practice appointment and number of long-term conditions once sociodemographic characteristics and health status were taken into account (5+conditions−OR=1.04, 95% CI 0.99 to 1.09), but there was a relationship for having enough support from local services to manage conditions (5+conditions−OR=0.84, 95% CI 0.80 to 0.88). Patients with multimorbidity that were younger, non-white or frail were less likely to have their needs fully met, both in GP and from local services. Differences between practices and local authorities explained minimal variation in unmet need.ConclusionsLevels of unmet need are high, particularly for support from community services to manage multiple conditions. Patients who could be targeted for support include people who feel socially isolated, and those who have difficulties with their day-to-day living. Younger patients and certain ethnic groups with multimorbidity are also more likely to have unmet needs. Increased personalisation and coordination of care among these groups may help in addressing their needs.


2021 ◽  
pp. 073346482110125
Author(s):  
Lawrence Schonfeld ◽  
Jesse Bell ◽  
Mary Goldsworthy ◽  
Kevin Kip ◽  
Amber M. Gum ◽  
...  

The National Aging Network serves millions of older Americans seeking home- and community-based services, but places others on waitlists due to limited resources. Little is known about how states determine service delivery and waitlists. We therefore conducted a process evaluation and analyzed data from one five-county Area Agency on Aging in Florida, where an algorithm calculates clients’ priority scores for service delivery. From 23,225 screenings over 5.5 years, clients with higher priority scores were older, married, living with caregivers, and had more health problems and needs for assistance. Approximately 51% received services (e.g., meals/nutrition, case management, caregiver support), 11% were eligible/being enrolled, and 38% remained on waitlists. Service status was complex due to multiple service enrollments and terminations, funding priorities, and transfers to third-party providers. More research is needed regarding how other states determine eligibility and deliver services, potentially informing national standards that promote optimal health in older Americans.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  

Abstract An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-726
Author(s):  
Damon Terzaghi

Abstract States are major policymakers and funders of community-based services for older Americans and ADvancing States played a significant role in supporting the OAA authorization this year. This presentation will provide the states' perspective regarding funding, services, research and demonstrations, and more.


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