Skip to main content
NCBI home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1990 Jan;80(1):39–46. doi: 10.2105/ajph.80.1.39

Post-hospital support program for the frail elderly and their caregivers: a quasi-experimental evaluation.

J S Oktay 1, P J Volland 1
PMCID: PMC1404530  PMID: 2152843

Abstract

This paper evaluates the Post-Hospital Support Program for the frail elderly and their caregivers using a quasi-experimental design. The program goals were to reduce stress in the caregivers, improve functioning and reduce mortality in patients, and reduce health service utilization in patients. Subjects were patients at the Johns Hopkins Hospital in Baltimore, Maryland, age 65 or over, who were returning home to the care of a non-paid caregiver and who had extensive post-hospital care needs which were expected to continue for at least one year. The 93 comparison group patient/caregiver pairs were discharged between May 15, 1983 and May 14, 1984. The 98 treatment group pairs were discharged between May 15, 1984 and May 14, 1985. Interviews were conducted with patients and caregivers at 1, 3, 6, 9, and 12 months after discharge. Results showed a slight reduction in caregiver stress and a substantial reduction in hospital days used by the treatment group. When confounding and history effects are taken into consideration, an average difference of 6.5 days per patients remains. The data also suggest that the treatment program may have postponed some deaths and nursing home placements. The results suggest that support services for the frail elderly and their caregivers can be cost efficient by reducing hospital length-of-stay. Savings were estimated at $4,585 per patient per year in this study. However, further work is needed to design programs which more effectively reduce caregiver stress.

Full text

PDF
39

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brody E. M. The Donald P. Kent Memorial Lecture. Parent care as a normative family stress. Gerontologist. 1985 Feb;25(1):19–29. doi: 10.1093/geront/25.1.19. [DOI] [PubMed] [Google Scholar]
  2. George L. K., Gwyther L. P. Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist. 1986 Jun;26(3):253–259. doi: 10.1093/geront/26.3.253. [DOI] [PubMed] [Google Scholar]
  3. Goldberg D. P., Hillier V. F. A scaled version of the General Health Questionnaire. Psychol Med. 1979 Feb;9(1):139–145. doi: 10.1017/s0033291700021644. [DOI] [PubMed] [Google Scholar]
  4. Harris J. F., Orr M., Allaway N. C. Long-term care criteria and standards agreement with professional placement determination. Am J Public Health. 1982 Jun;72(6):602–604. doi: 10.2105/ajph.72.6.602. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. KAHN R. L., GOLDFARB A. I., POLLACK M., GERBER I. E. The relationship of mental and physical status in institutionalized aged persons. Am J Psychiatry. 1960 Aug;117:120–124. doi: 10.1176/ajp.117.2.120. [DOI] [PubMed] [Google Scholar]
  6. KATZ S., FORD A. B., MOSKOWITZ R. W., JACKSON B. A., JAFFE M. W. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914–919. doi: 10.1001/jama.1963.03060120024016. [DOI] [PubMed] [Google Scholar]
  7. Lawton M. P., Brody E. M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed] [Google Scholar]
  8. Lawton M. P., Brody E. M., Saperstein A. R. A controlled study of respite service for caregivers of Alzheimer's patients. Gerontologist. 1989 Feb;29(1):8–16. doi: 10.1093/geront/29.1.8. [DOI] [PubMed] [Google Scholar]
  9. Liu K., Manton K. G., Liu B. M. Home care expenses for the disabled elderly. Health Care Financ Rev. 1985 Winter;7(2):51–58. [PMC free article] [PubMed] [Google Scholar]
  10. Soldo B. J., Manton K. G. Health status and service needs of the oldest old: current patterns and future trends. Milbank Mem Fund Q Health Soc. 1985 Spring;63(2):286–319. [PubMed] [Google Scholar]
  11. Vladeck B. C. Reforming Medicare provider payment. J Health Polit Policy Law. 1985 Fall;10(3):513–532. doi: 10.1215/03616878-10-3-513. [DOI] [PubMed] [Google Scholar]
  12. Waldo D. R., Lazenby H. C. Demographic characteristics and health care use and expenditures by the aged in the United States: 1977-1984. Health Care Financ Rev. 1984 Fall;6(1):1–29. [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES