Several policy issues pertaining to long-term care (LTC) were assessed, and they include (1) What are the cost-effective alternatives in long-term care? (2) What are the major societal and individual factors that are amenable to program interventions for reducing unnecessary and inappropriate institutionalization of the chronically ill? (3) What are the critical elements of a successful evaluation research design in long-term care? (4) How can LTC research findings be transmitted into policy relevant guides for program planning and development? The strengths and weaknesses of a variety of evaluation designs in long-term care research were discussed.
Get full access to this article
View all access options for this article.
References
1.
Applegate, W. B.
, D. Akins, R. VanderZwaag, K. Thoni, and M. G. Baker1983"A geriatric rehabilitation and assessment unit in a community hospital."J. of the Amer. Geriatrics Society31, 4: 206-210.
2.
Barney, J. L.1977"The prerogative of choice in long-term care."Gerontologist17: 309-314.
3.
Berg, R. L.et al.1970"Assessing the health care needs of the elderly."Health Services Research5: 36-59.
4.
Branch, L. G.
and A. M. Jette1982"A prospective study of long-term care institutionalization among the aged."Amer. J. of Public Health72 (December): 1380-1385.
5.
Brody, S. J.et al.1978"The family caring unit: a major consideration in the long-term support system."Gerontologist18: 556-560.
6.
Carr, W. S.
and S. Wolfe1979"Unmet needs as sociomedical indicators," in J. Elinson and A. Siegmann (eds.) Socio-Medical Health Indicators. Farmingdale, NY: Baywood.
7.
Casey, S. 1979 "Executive summary of path analysis of causal models of nursing home use: an exploratory study of Illinois counties." Ph.D. dissertation, Southern Illinois University, Carbondale, Illinois.
8.
Chiswick, B. R.1975"The demand for nursing home care: an analysis of the substitution between institutional and noninstitutional care."J. of Human Resources11: 295-316.
9.
Davis, K.1975"Equal treatment and unequal benefits: the Medicare program."Milbank Memorial Fund Q.53: 449-488.
10.
Eggert, G. M.et al.1980"Gaining control of the long-term care system: first returns from the ACCESS experiment."Gerontologist20, 3: 356-363.
11.
Falcone, A. R.1979Development of a Long-Term Care Information System. East Lansing, MI: Michigan Office of Services to the Aging.
12.
Foley, W.
and D. P. Schneider1980"A comparison of the level of care predictions of six long-term care patient assessment systems."Amer. J. of Public Health70, 11: 1152-1161.
13.
Fries, B. E.
and L. M. Cooney1983A Patient Classification System for Long-Term Care. A report submitted to Health Care Financing Administration.
14.
Greenberg, J. N.
and A. Ginn1979"A multivariate analysis ofthe predictors of long-term care placement."Home Health Care Services Q.1, 1: 75-99.
15.
Jones, E. W.et al.1974Patient Classification for Long-Term Care: User's Manual. Rockville, MD: Health Resources Administration.
16.
Kahn, R. L.
, M. Pollack, and A. I. Goldfarb1961"Factors related to individual differences in mental status of institutionalized age," in P. Heck and J. Zubin (eds.) Psychology of Aging. New York: Grune & Stratton.
17.
Katz, S.
, S. C. Hedrick, and N. S. Henderson1963"The measurement of long-term care needs and impact."Health and Medical Services Rev.2, 1: 1-21.
18.
Kraus, A. L.
, R. A. Spasoff, E. J. Beattie, D.E.W. Holden, J. S. Lawson, M. Rodenburg, and G. M. Woodcock1976"Elderly applicants to long-term care institutions, I: their characteristics, health problems and state of mind."J. of Amer. Geriatrics Society24: 165-172.
19.
Lamont, C. T.
, S. Sampson, R. Matthias, and R. Kane1983"The outcome of hospitalization for acute illness in the elderly."J. of the Amer. Geriatrics Society31, 5: 282-288.
20.
Lefton, E.
, S. Bonstelle, and J. D. Frengley1983"Success with an inpatient geriatric unit: a controlled study of outcome and follow-up."J. of the Amer. Geriatrics Society31, 3: 149-155.
21.
McCoy, J. L.
and B. E. Edwards1981"Contextual and sociodemographic antecedents of institutionalization among aged welfare recipients."Medical Care19, 9: 907-921.
22.
National Center for Health Statistics1979Long-Term Health Care Minimum Data Set. Hyattsville, MD: National Center for Health Statistics.
23.
Nielsen, M.
, M. Blenkner, M. Bloom, T. Downs, and H. Beggs1972"Older persons after hospitalization: a controlled study of home aide service."Amer. J. of Public Health62: 1094-1101.
24.
Palmore, E.1976"Total chance of institutionalization among the aged."Gerontologist16: 504-507.
25.
Plomann, M. P.1982Case Mix Classification Systems: Development, Description and Testing. Chicago, IL: The Hospital Research and Educational Trust, American Hospital Association.
26.
Ricker-Smith, K. L.1982"A challenge for public policy: the chronically ill elderly and nursing homes."Medical Care20, 11: 1071-1079.
27.
Scanlon, W.
, E. DiFederico, and M. Stassen1979Long-Term Care: Current Experience and a Framework for Analysis. Washing- ton, DC: Urban Institute.
28.
Seidl, F. W.
, R. Applebaum, C. Austin, and K. Mahoney1983Delivery In-Home Services to the Aged and Disabled: The Wisconsin Experiment. Lexington, MA: Lexington Books.
29.
Sherwood, S.
, C. Sherwood, and J. N. Morris1974"Preinstitutionalization factors as predictors of adjustment to a long-term care facility."Int. J. of Aging and Human Development5, 1: 95-105.
30.
Steel, K.
, E. Markson, C. Crescenzi, S. Hoffman, and A. Bissonnette1982"An analysis of types and costs of health care services provided to an elderly inner city population."Medical Care20, 11: 1090-1100.
31.
Townsend, P.1965"The effects of family structure on the likelihood of admission to an institution in old age: the application of a general theory," in E. Shanas and G. F. Streib (eds.) Social Structure and the Family. Englewood Cliffs, NJ: Prentice-Hall.
32.
Vincente, L.
, J. A. Wiley, and R. A. Carrington1981"Duration of stay and other aspects of nursing home use."Int. J. of Aging and Human Development12: 301-311.
33.
Viadek, B. C.1980Unloving Care: The Nursing Home Tragedy. New York: Basic Books.
34.
Wan, T.T.H.1983Quantitative Analysis and Evaluation Research Methods. (unpublished)
35.
Wan, T.T.H.
and B. G. Odell1981"Factors affecting the use of social and health services for the elderly."Aging and Society1, 1: 95-115.
36.
Wan, T.T.H.
, B. G. Odell, and D. T. Lewis1982Promoting the Well-Being of the Elderly. New York: Haworth.
37.
Wan, T.T.H.
and D. Singley1983"Psychological symptoms, social support, and use of health-social services by functionally disabled elders," in C. Tilquin (ed.) Systems Science in Health- Social Services for the Elderly and the Disabled. Montreal, Canada: International Institute for Systems Science in Health Care.
38.
Wan, T.T.H.
and W. G. Weissert1981"Social support networks, patient status, and institutionalization."Research on Aging3, 2: 240-256.
39.
Wan, T.T.H.
, W. G. Weissert, and B. B. Livieratos1980"Geriatric day care and homemaker services: an experimental study,"J. of Gerontology35, 2: 256-274.
40.
Wasserman, J.1982DRG Evaluation Volume I: Introduction and Overview. Princeton, NJ: Health Research and Educational Trust of New Jersey.
41.
Weissert, W. G.1978"Long-term care: An overview," in Health United States, 1978. Hyattsville, MD: Office of the Assistant Secretary for Health, Department of Health, Education, and Welfare.
42.
Weissert, W. G.
, W. J. Scanlon, T.T.H. Wan, and D. E. Skinner1983"Encouraging appropriate care for the chronically ill: design of an experiment in patient based nursing home incentive payments."Health Care Financing Rev.5, 2: 4149.
43.
Weissert, W. G.
, T.T.H. Wan, B. Livieratos, and S. Katz1980a"Cost-effectiveness of day care services for the chronically ill: a randomized experiment."Medical Care 18, 6: 567-584.
44.
Weissert, W. G.
, T.T.H. Wan, B. B. Livieratos, and J. Pellegrino1980b"Cost-effectiveness of homemaker services for the chronically ill."Inquiry17: 230-243.
