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The Past and Future of Home‐ and Community‐Based Long‐Term Care
Author(s) -
WEISSERT WILLIAM G.,
CREADY CYNTHIA MATTHEWS,
PAWELAK JAMES E.
Publication year - 2005
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/j.1468-0009.2005.00434.x
Subject(s) - long term care , population , medicine , gerontology , unit (ring theory) , psychology , nursing , environmental health , mathematics education
or m ore t han t hree d ecades, r esearchers h ave sought to quantify the benefits of home care. Recent studies have also assessed costs, invariably on the assumption that home care— later called home and community care—would substitute for institu- tional care and thereby save money. Dozens of studies—some very weak methodologically, others quite strong—have contributed to a substan- tial body of findings on the topics. The studies have varied not only in methods, but also in other important ways, including services offered, populations targeted, patients studied, and impacts assessed. This article reviews the results of home and community care studies conducted over the last several decades. Over 700 citations were ex- amined. All studies conducted after 1960 were included in the review provided they met five criteria: (1) they tested the effects of providing a home- and community-based alternative to existing long-term care ser- vices (which in some studies included other home- and community-based services as well as services provided in an institution); (2) they used an ex- perimental design that included a treatment and control group; (3) they included at least 50 individuals in each study group; (4) they used the individual as their primary unit analysis; and (5) they served primarily an elderly population.