Prepared by: R. William Thomas Abt Associates Prepared for: Office of the Assistant Secretary for Planning and Evaluation Department of Health, Education, and Welfare Contract: HEW-100-76-0179 Each chapter of the Report is in PDF format. Download a copy of the reader .
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In-Home Supportive Services for the Elderly and Disabled: A Comparison of Client-Directed and Professional Management Models of Services Delivery--Non-Technical Summary Report
Elderly and younger persons with disabilities who require help from others to perform many of the most ordinary activities of daily living are said to require "long-term care." These services, when provided in the home or other non-institutional settings, may be termed personal assistance services, home and community-based services, or in-home sup
This study examines the impact of changes in Medicare home health policy mandated by the Balanced Budget Act (BBA) of 1997 on satisfaction with care for disabled Medicare beneficiaries. The BBA mandated major changes in home health payment requiring the implementation of a Prospective Payment System (PPS) and an Interim Payment System (IPS) prior
The activities of daily living (ADLs) are the basic task of everyday life: eating, bathing, dressing, toileting, and transferring. Although persons of all ages may have problems performing ADLs, disability prevalence rates are much higher for the elderly rising steeply with advancing age. When an effort is made to standardize ADL items for com
This paper discusses the policy implications of allocating long-term care benefits to the elderly on the basis of objective functional criteria, particularly functioning in the activities of daily living (ADLs). Although research has documented the link between measures of ADL performance and the need for services, developing a long-term care prog
An analysis was made of the pre and post-patterns of Medicare Part A service use using the samples of the 1982 and 1984 National Long-Term Care Surveys linked to the Medicare Part A bill files and mortality reports. The analysis was conducted both for the total elderly Medicare beneficiary population and for the community resident disabled populat
Factors Associated with Ending Caregiving Among Informal Caregivers to the Functionally and Cognitively Impaired Elderly Population
This study investigated factors associated with the decisions of principal informal caregivers of the activity of daily living (ADL) dependent elderly living in the community to end caregiving. Data were from the 1982 National Long-Term Care Survey (NLTCS), the 1982 Informal Caregiver Survey and 1984 NLTCS Longitudinal Follow-up.
This report analyzed data on all pediatric hospitalizations of $25,000 or more in California to determine the relationship between source of payment and various characteristics, including age and diagnosis. [39 PDF pages]
This is the second in a series of four reports that summarize study findings and methods. This report presents descriptive findings on the characteristics of board and care facilities, operators, staff, and residents. Section 2 briefly describes the study design and sampling and analytic methodology; more detailed discussion is presented in the Te
This paper addresses issues which arise at the juncture of welfare and disability policies. Using preliminary data from a recent survey of current and recent AFDC recipients in California, we find that disabilities and chronic health problems affect the mothers or children in 43% of all households in the AFDC system. The presence of one or more ch
In 1992, Lewin-VHI produced the report Policy Synthesis on Assisted Living for the Frail Elderly in order to address: the policy concerns generated by a growing frail elderly population, rapid increases in costs of care, and growing interest in various types of supportive housing for the elderly. The 1992 Policy Synthesis was based on a review and
This paper was requested as part of the National Academy of Sciences, Committee on National Statistics Panel to Evaluate the Survey of Income and Program Participation (SIPP). SIPP is sponsored by the Bureau of the Census and has been an ongoing longitudinal survey of the civilian non-institutionalized population since 1983.
This comparative study first identifies and describes two cohorts of nursing facility decedents, those that did and did not elect Medicare hospice. Then, using data for up to one year prior to death, the study characterizes utilization and quality of care for these two cohorts. The influence of Medicare hospice on hospital utilization and symptom
This collection of brief issue papers uses diverse data to describe 15 major problems facing American children and families. Each paper summarizes the state of knowledge about the scope of the problem, trends, current government expenditures, costs per case, effectiveness of current intervention strategies and public attitudes about the problem ar
Exploratory Study of Health Care Coverage and Employment of People with Disabilities: Literature Review
This literature review examines empirical evidence on health care coverage, employment, and public program participation among people with disabilities. The review is part of a larger project investigating the relationship between health care coverage and the employment of people with disabilities contracted for by the Office of Disability, Aging
This report presents the results of an evaluability assessment of discharge/transition planning as a homeless prevention strategy in four types of institutional and custodial settings including: adult in-patient psychiatric hospitals, foster care independent living programs, residential treatment programs for adults with substance abuse disorders,