scholarly journals The Use Patterns of Medicaid Home and Community Based Services Among Medicare/Medicaid Beneficiaries With Dementia

2021 ◽  
Vol 9 ◽  
Author(s):  
Di Yan ◽  
Sijiu Wang ◽  
Helena Temkin-Greener ◽  
Shubing Cai
Keyword(s):  
Community Based ◽  
Use Patterns ◽  
Medicaid Beneficiaries ◽  
Community Based Services

Use of Home- and Community-Based Services in Taiwan’s National 10-Year Long-Term Care Plan

2018 ◽  
Vol 39 (7) ◽  
pp. 722-730 ◽  
Author(s):  
Hsiao-Wei Yu ◽  
Yu-Kang Tu ◽  
Po-Hsiu Kuo ◽  
Ya-Mei Chen
Keyword(s):  
Daily Living ◽  
Long Term Care ◽  
Care Group ◽  
Community Based ◽  
Term Care ◽  
Use Patterns ◽  
Care Recipients ◽  
Home Based ◽  
Community Based Services

We aimed to understand the relationships between care recipients’ profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

scholarly journals Home- and Community-Based Services Use Patterns and Functional Improvement among Older Care Recipients in Taiwan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 906-907
Author(s):  
Hsiao-Wei Yu ◽  
Shih-Cyuan Wu ◽  
Ya-Mei Chen
Keyword(s):  
Long Term Care ◽  
Functional Improvement ◽  
Community Based ◽  
Term Care ◽  
Use Patterns ◽  
Care Services ◽  
Care Recipients ◽  
Home Based ◽  
Community Based Services

Abstract The new version of Taiwan’s 10-Year Long-Term Care Plan launched in 2016 aims to reinforce the integration of home- and community-based services (HCBS). The underlying HCBS use patterns and effectiveness of functional improvement among care recipients merit investigation. The purpose of the study was to examine the association of HCBS and changes in ADLs among care recipients with different levels of disabilities in Taiwan. We accessed the sub data of Taiwan’s Long-Term Care Services Management Online System. Samples were aged 65 and over and had completed records of baseline and reassessment information during 2018 (N = 4787). Latent class analysis and multivariate linear regression were applied to examine the relationship of HCBS and functional changes. Four HCBS subpatterns were found: home-based personal care services (home-based PS) (59.16%), home-based reablement services (home-based RS) (23.90%), home-based multiple services (home-based MS) (11.93 %), and community-based services (5.01%). In the cases with mild disabilities at baseline, recipients receiving home-based RS had higher probabilities of improving in ADLs among four HCBS subgroups (for example: β = 2.65, SE = 1.19 in comparison to home-based PS). Care recipients with moderate-to-severe disability at baseline, ADLs improvement was only found in home-based PS (β = 1.63, SE = 0.82 in comparison of home-based MS). In the cases with profound disabilities, home-based PS showed positive effects on ADLs improvement (β = 2.45, SE = 0.80 in ADLs, compared to home-based RS). The study suggested that HCBS subpatterns had different impacts on older adults with different disability levels.

A Study on the Estimation of Community-Based Services Demands for the Management of Patients with Alcohol Use Disorder

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

scholarly journals Are the needs of people with multiple long-term conditions being met? Evidence from the 2018 General Practice Patient Survey

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041569
Author(s):  
Lucina Rolewicz ◽  
Eilís Keeble ◽  
Charlotte Paddison ◽  
Sarah Scobie
Keyword(s):  
General Practice ◽  
Unmet Need ◽  
Patient Survey ◽  
Secondary Outcome ◽  
Community Based ◽  
Long Term Conditions ◽  
Local Services ◽  
Community Based Services ◽  
Practice Patient

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.

Screening and Priority-Setting to Determine Home- and Community-Based Aging Services for Older Floridians

2021 ◽  
pp. 073346482110125
Author(s):  
Lawrence Schonfeld ◽  
Jesse Bell ◽  
Mary Goldsworthy ◽  
Kevin Kip ◽  
Amber M. Gum ◽  
...  
Keyword(s):  
Service Delivery ◽  
National Standards ◽  
Third Party ◽  
Community Based ◽  
Older Americans ◽  
Caregiver Support ◽  
Aging Services ◽  
Optimal Health ◽  
Aging Network ◽  
Community Based Services

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.

scholarly journals All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  
Keyword(s):  
Service Use ◽  
Service Providers ◽  
Theory And Practice ◽  
Community Based ◽  
Daily Diaries ◽  
Rural Caregivers ◽  
Service Expectations ◽  
Extensive Body ◽  
Barriers To Health ◽  
Community Based Services

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.

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