Abstract
This article reports the outcomes of a four-year follow-up evaluation of the Five Hospital Program, a long-term home care program in Chicago. Outcomes assessed include the mortality, comprehensive functional status, and perceived unmet needs of its frail elderly clientele (mean age 81 years at entry). The evaluation utilized a pretest, multiple posttest design with a comparison group consisting of similarly elderly and impaired individuals receiving OAA Title III-C home-delivered meals. Consecutively accepted treatment (N = 157) and comparison group clients (N = 156) were interviewed using the OARS Multidimensional Functional Assessment Questionnaire at baseline, 9 months, and 48 months after acceptance to care. A multivariate analysis of mortality rates revealed no between-group differences attributable to treatment on this outcome. Major findings included significantly better cognitive functioning and reduced unmet needs in the treatment group at nine months. A longer-range, continued beneficial effect of treatment on cognitive status was also observed at 48 months. We conclude that long-term home care provided important benefits to clients at both 9 and 48 months, with no effect on mortality. However, we suggest that the four-year findings be interpreted with caution, since only a small percentage of clients (18 percent) were still alive and receiving active care in the community at that time.
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Selected References
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- Hicks B., Raisz H., Segal J., Doherty N. The triage experiment in coordinated care for the elderly. Am J Public Health. 1981 Sep;71(9):991–1003. doi: 10.2105/ajph.71.9.991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hughes S. L. Apples and oranges? A review of evaluations of community-based long-term care. Health Serv Res. 1985 Oct;20(4):461–488. [PMC free article] [PubMed] [Google Scholar]
- Hughes S. L., Manheim L. M., Edelman P. L., Conrad K. J. Impact of long-term home care on hospital and nursing home use and cost. Health Serv Res. 1987 Apr;22(1):19–47. [PMC free article] [PubMed] [Google Scholar]
- Katz S., Downs T. D., Cash H. R., Grotz R. C. Progress in development of the index of ADL. Gerontologist. 1970 Spring;10(1):20–30. doi: 10.1093/geront/10.1_part_1.20. [DOI] [PubMed] [Google Scholar]
- LaTour S. A., Friedman B., Hughes E. F. Medicare beneficiary decision making about health insurance. Implications for a voucher system. Med Care. 1986 Jul;24(7):601–614. doi: 10.1097/00005650-198607000-00004. [DOI] [PubMed] [Google Scholar]
- Mitchell J. B. Patient outcomes in alternative long-term care settings. Med Care. 1978 Jun;16(6):439–452. doi: 10.1097/00005650-197806000-00001. [DOI] [PubMed] [Google Scholar]
- Nielsen M., Blenkner M., Bloom M., Downs T., Beggs H. Older persons after hospitalization: a controlled study of home aide service. Am J Public Health. 1972 Aug;62(8):1094–1101. doi: 10.2105/ajph.62.8.1094. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975 Oct;23(10):433–441. doi: 10.1111/j.1532-5415.1975.tb00927.x. [DOI] [PubMed] [Google Scholar]
- Skellie F. A., Coan R. E. Community-based long-term care and mortality: preliminary findings of Georgia's alternative health services project. Gerontologist. 1980 Jun;20(3 Pt 1):372–379. doi: 10.1093/geront/20.3_part_1.372. [DOI] [PubMed] [Google Scholar]
