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Medical Foster Homes: Can the Adult Foster Care Model Substitute for Nursing Home Care?
Author(s) -
Levy Cari,
Whitfield Emily A.
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14517
Subject(s) - medicine , comorbidity , gerontology , health care , long term care , propensity score matching , veterans affairs , nursing homes , family medicine , nursing , psychiatry , economics , economic growth
Objective To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration ( VHA ) medical foster home ( MFH ) with those of three other VHA long‐term care ( LTC ) programs. Design Descriptive, unmatched study. Setting VHA MFH s, home‐based primary care ( HBPC ), community living centers ( CLC s), and community nursing homes ( CNH s). Participants Veterans newly enrolled in one of the four LTC settings in calendar years 2010 or 2011. Measurements Using VA and Medicare data from fiscal years 2010 and 2011, demographic characteristics, healthcare use, and costs of 388 veterans in MFH s were compared with 26,037 of those in HBPC , 5,355 in CLC s, and 5,517 in CNH s in the year before and the year after enrollment. Results Veterans enrolled in the MFH program were more likely to be unmarried than those in other LTC programs and had higher levels of comorbidity and frailty than veterans receiving HBPC but had similar levels of comorbidity, frailty, and healthcare use as those in CLC s and CNH s. MFH veterans incurred lower costs than those in CNH s and CLC s. Conclusion MFH s served a distinct subset of veterans with levels of comorbidity and frailty similar to those of veterans cared for in CLC s and CNH s at costs that were comparable to or lower than those of the VHA . Propensity‐matched comparisons will be necessary to confirm these findings.