scholarly journals Risk of Hospitalization Associated With Different Constellations of Home & Community Based Services

2021 ◽  
Author(s):  
Ray Van Cleve ◽  
Evan Cole ◽  
Howard Degenholtz
Keyword(s):  
Initial Level ◽  
Secondary Data ◽  
Community Dwelling ◽  
Adult Day Care ◽  
Community Based ◽  
Inpatient Hospitalization ◽  
Medicaid Population ◽  
Low Levels ◽  
To Receive ◽  
Community Based Services

Abstract Background:Identify the association between specific combinations of home and community-based services (HCBS) and risk of acute hospitalization. Methods:Data for this study came from Pennsylvania Medicaid claims, enrollment files, enrollee evaluations, and Medicare and Medicaid hospitalization records. This analysis compared risk of inpatient hospitalization across an entire state Medicaid population of community dwelling elderly individuals receiving HCBS. Twelve constellations of HCBS were identified, each composed of different services. Using logistic regression, we derived predicted probabilities of experiencing hospitalization for people in each constellation. This was secondary data analysis conducted outside of a hospital. This study used observational data. There was no randomization.Results:The highest risk of hospitalization, 15.1%, was associated with use of home delivered meals and low levels of PAS. The lowest risk of hospitalization, 7.5% was associated with use of adult day care and low levels of PAS. An 11.6% risk of hospitalization was associated with people who had applied to receive HCBS but were deemed ineligible. This risk was higher than all other constellations of HCBS except for the risk associated with using only low levels of PAS (13.9%) and using low levels of PAS and home delivered meals (15.1%). Conclusions: Using medium and high levels of PAS was associated with lower hospitalization risk compared to only low levels of PAS. Offering a higher initial level of PAS upon enrollment in Medicaid could potentially reduce hospitalization risk. People receiving home delivered meals had an elevated hospitalization risk.

DEINSTITUTIONALIZATION OF THE CHILD CARE SYSTEM IN LITHUANIA

2020 ◽  
Vol 11 (4.1) ◽  
pp. 121-131
Author(s):  
Jolanta Pivoriene
Keyword(s):  
Child Care ◽  
Necessary Conditions ◽  
Institutional Care ◽  
Secondary Data ◽  
Community Based ◽  
Political Discourses ◽  
Qualitative Evidence ◽  
To Receive ◽  
Community Based Services ◽  
Care System

The reform of the child care system in Lithuania started with the Ministry of Social Security and Labor approving the Strategic Guidelines for Deinstitutionalization in 2012, followed by the Transition from Institutional Care to Community-Based Services in 2014. The strategic aim of the reform was to create a system including a comprehensive range of services that would enable every child and their family or guardians to receive individual services as well as community assistance according to their needs. The process of transformation of institutional care was designed in two steps: creation of the necessary conditions for the transformation, which took place in 2014 to 2017, and development of infrastructure in the regions, planned for 2017 to 2020, but now extended to 2023. The goal of this article is to discuss the deinstitutionalization process by presenting legal regulations, information about the conceptualization and scope of the project, and evidence based on documents and statistical and secondary data analysis. I will also discuss possible contradictions between analytical and political discourses, and quantitative and qualitative evidence.

Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

METODE K-MEANS DALAM PEMETAAN PENYEBARAN PAMSIMAS

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Ego Dwi Pratomo ◽  
Tri Irawati ◽  
Wawan Laksito Yuly Saptomo
Keyword(s):  
Secondary Data ◽  
Primary Data ◽  
Mapping Study ◽  
Government Programs ◽  
Community Based ◽  
State Budget ◽  
Suburban Communities ◽  
The Right ◽  
To Receive ◽  
Selection Of

Program water supply and sanitation water the community (Pamsimas) is one of the government's mainstay programs in the provision of clean water and sanitation for rural and suburban communities through a community-based approach. With the effort to determine which villages are categorized as potential to receive financial assistance and no potential to receive APBN assistance for the installation of the project pamsimas. The aim is to establish a standard system for selecting Pamsimas villages to help government programs channel them to the right target. With the K-Means Clustering clustering method, this method is very suitable to be used in predicting and classifying which villages are categorized as potentials and does not have the potential to detect the state budget for the Pamsimas project installation. The data is taken interview and direct observation to the Pamsimas office which is the primary data and the criteria data in the form of village data and village connections are secondary data. The results obtained are the K-Means method can be applied clustering of Pamsimas Karanganyar village clustering which is useful to assist the selection of villages on target. By testing the functionality using a black box and testing the validity using the Rapidminer Software. In the mapping study, it was stated that 2 clusters were categorized as potential and not potential. For the results of a valid percentage of the Pamsimas application is 100%.Keywords: Mapping, Pamsimas, Clustering K-Means. 

Location Matters: Disparities in the Likelihood of Receiving Services in Late Life

2020 ◽  
pp. 009141502094820
Author(s):  
Raven H. Weaver ◽  
Karen A. Roberto
Keyword(s):  
Older Adults ◽  
Service Delivery ◽  
Home Care ◽  
Rural Areas ◽  
Late Life ◽  
Community Based ◽  
Fresh Food ◽  
Delivery Strategies ◽  
To Receive ◽  
Community Based Services

Moving beyond typical dichotomous rural–urban categorizations, this study examines older adults’ likelihood of receiving home- and community-based services. Data from 1608 individuals aged 60+ who requested assistance from Area Agencies on Aging in Virginia in 2014–2015 were analyzed; 88% of individuals received at least one service. Receiving services was associated with geographic-based factors. Individuals living in completely rural areas were significantly less likely to receive any service compared to individuals in mostly rural (OR = 2.46, p = .003) and mostly urban (OR = 1.97, p = .024) areas. There were subtle but significant geographic-based differences in the likelihood of receiving specific services including food/meal, fresh food, information and referral, in-home care, utilities support, and transportation. Findings provide nuanced insights about geographic-based disparities in the receipt of services and suggest the need for new and modified service delivery strategies that maximize older adults’ ability to live.

Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services

2011 ◽  
Vol 52 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Masafumi Kuzuya ◽  
Jun Hasegawa ◽  
Yoshihisa Hirakawa ◽  
Hiromi Enoki ◽  
Sachiko Izawa ◽  
...  
Keyword(s):  
Informal Care ◽  
Community Dwelling ◽  
Community Based ◽  
Dependent Elderly ◽  
Community Based Services ◽  
At Home

Gender and Transportation Access among Community-Dwelling Seniors

2007 ◽  
Vol 26 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Josette Dupuis ◽  
Deborah R. Weiss ◽  
Christina Wolfson
Keyword(s):  
Unmet Needs ◽  
Community Dwelling ◽  
Social Effects ◽  
Urban Setting ◽  
Lower Income ◽  
Community Based ◽  
Multivariable Analyses ◽  
Design And Methods ◽  
Community Based Services ◽  
Income Satisfaction

ABSTRACTPurpose: This study estimates the prevalence of problems with transportation in a sample of community-dwelling seniors residing in an urban setting and investigates the role that gender plays in the ability of seniors to remain mobile in their communities.Design and Methods: Data collected as part of a study assessing the prevalence and consequences of unmet needs for community-based services in a random sample of 839 elderly aged 75 years and older were employed in bivariate and multivariable analyses.Results: The prevalence of problems with transportation was 23 per cent, with 33 per cent of females and 10 per cent of males categorized as having problems with transportation. Of those subjects categorized as having problems with transportation, 88 per cent were women. In addition to being predominantly women, those who reported problems with transportation were older, in poorer health, and had lower income and income satisfaction.Implications: Problems with transportation are an important issue facing seniors; women, in particular. These results highlight the differences in aging as experienced by women and men with respect to social effects, needs, and the significance attached to the experience.

scholarly journals The Effect of Home- and Community-Based Services on Activity Engagement

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 840-840
Author(s):  
Peter Sun
Keyword(s):  
Social Engagement ◽  
Social Cognitive ◽  
Average Treatment Effect ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Estimation Model ◽  
Community Based ◽  
Activity Engagement ◽  
Treatment Groups ◽  
Community Based Services

Abstract This study examined the association between home- and community-based services (HCBS) and social, cognitive, and physical engagement among community-dwelling older adults in the U.S. Data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of respondents ages 50 and over who answered questions on HCBS utilization and activity engagement (n = 567). Genetic matching and propensity score weighting were used to mimic randomized control and treatment groups, in order to estimate the population average treatment effect on the treated (PATT). HCBS utilization was found to be significantly associated with social engagement (PATT = 0.17, SE = 0.05, p < 0.05) and physical (PATT = -0.20, SE = 0.07, p < 0.05) engagement but not significantly associated with cognitive engagement (PATT = -0.04, SE = 0.12, p > 0.05). Sensitivity analyses found that the results were robust to the estimation model. These findings suggest that HCBS utilization is a promising model for increased activity engagement, and future policies aimed at targeting these outcomes are warranted.

Sign in / Sign up

Export Citation Format

Share Document