2.50
Hdl Handle:
http://hdl.handle.net/10755/155756
Type:
Presentation
Title:
Outcomes of a Community-based Program for Elders
Abstract:
Outcomes of a Community-based Program for Elders
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Neese, Jane, PhD
P.I. Institution Name:University of North Carolina-Charlotte
Title:Associate Professor
Objective: To determine the differences in health outcomes, costs, and service use between impoverished elders participating in a community – based program versus impoverished elders who were not receiving similar services. Design: This was a three-year, longitudinal study with a static group comparison design. Population, Sample, Setting, Years: Of the total sample of 153 randomly selected elders aged 65 years and older residing in public housing, 76 participated in the community-based program and 77 participants were in the control group. The majority of the sample was in the middle old age group (X = 75; SD = 8.7; Range: 65 – 95 years), African Americans (68%), female (80%), lived alone (96%), and widowed (56%). The study was conducted in an urban setting with impoverished older adults over a three-year period. Concept or Variables Studied Together or Intervention and Outcome Variables: The intervention is the delivery of multidisciplinary team’s services to elders in their residential sites. The health outcome variables are the following: blood pressure, functional status (ADLs, IADLs, Iowa Self-Assessment Inventory), cognition (MMSE, 3MS), depression (CES-D, DMAS), quality of life (SASI), number of medications (prescribed and OTC), sleep and nutrition. The health services variables are: annual hospital admissions and length of stay, annual nursing home admissions and length of stay, annual home health visits, annual outpatient visits, and annual physician visits. All health services data were extracted from Medicare A & B files from the Health Care Financing Administration, a national database of health services. Methods: Informed consent was obtained to collect Medicare information and to conduct interviews every six months. Health outcome data were collected via interview in the elders’ homes for three years. Cost analysis was conducted using direct and indirect cost in addition to the payments to Medicare. Health services were collected over a two-year period from the Medicare A & B files from HCFA. Findings: During the three years, the control group was less impaired in their ADLs, IADLs, cognition, and mobility as compared to the community group. Over time, the community group improved in cognition and depression and maintained in the other domains of functioning. Although there were no significant differences between the two groups in health service use over time, there were cost-savings within the NOP group than the control group. Conclusions: The community group sites initially were targeted as the frailest group of elders residing in public housing. Although the community group did not significantly exceed the health outcomes of the control group, maintaining function is in itself an improvement over a decline in functioning. Over time, the community group improved in cognition and depression, which could be attributed to attrition in this older, frail adult group. There were a small percentage of cost saving among the NOP group assisting in the sustainability of this community-based program. Implications: Even though significant health outcome and health service use between the two groups were not observed, the community group was able to maintain their present level of functioning and remain living independently in the community. This research also addresses the difficulty in health services research.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleOutcomes of a Community-based Program for Eldersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155756-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Outcomes of a Community-based Program for Elders</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Neese, Jane, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of North Carolina-Charlotte</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jbneese@email.uncc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To determine the differences in health outcomes, costs, and service use between impoverished elders participating in a community &ndash; based program versus impoverished elders who were not receiving similar services. Design: This was a three-year, longitudinal study with a static group comparison design. Population, Sample, Setting, Years: Of the total sample of 153 randomly selected elders aged 65 years and older residing in public housing, 76 participated in the community-based program and 77 participants were in the control group. The majority of the sample was in the middle old age group (X = 75; SD = 8.7; Range: 65 &ndash; 95 years), African Americans (68%), female (80%), lived alone (96%), and widowed (56%). The study was conducted in an urban setting with impoverished older adults over a three-year period. Concept or Variables Studied Together or Intervention and Outcome Variables: The intervention is the delivery of multidisciplinary team&rsquo;s services to elders in their residential sites. The health outcome variables are the following: blood pressure, functional status (ADLs, IADLs, Iowa Self-Assessment Inventory), cognition (MMSE, 3MS), depression (CES-D, DMAS), quality of life (SASI), number of medications (prescribed and OTC), sleep and nutrition. The health services variables are: annual hospital admissions and length of stay, annual nursing home admissions and length of stay, annual home health visits, annual outpatient visits, and annual physician visits. All health services data were extracted from Medicare A &amp; B files from the Health Care Financing Administration, a national database of health services. Methods: Informed consent was obtained to collect Medicare information and to conduct interviews every six months. Health outcome data were collected via interview in the elders&rsquo; homes for three years. Cost analysis was conducted using direct and indirect cost in addition to the payments to Medicare. Health services were collected over a two-year period from the Medicare A &amp; B files from HCFA. Findings: During the three years, the control group was less impaired in their ADLs, IADLs, cognition, and mobility as compared to the community group. Over time, the community group improved in cognition and depression and maintained in the other domains of functioning. Although there were no significant differences between the two groups in health service use over time, there were cost-savings within the NOP group than the control group. Conclusions: The community group sites initially were targeted as the frailest group of elders residing in public housing. Although the community group did not significantly exceed the health outcomes of the control group, maintaining function is in itself an improvement over a decline in functioning. Over time, the community group improved in cognition and depression, which could be attributed to attrition in this older, frail adult group. There were a small percentage of cost saving among the NOP group assisting in the sustainability of this community-based program. Implications: Even though significant health outcome and health service use between the two groups were not observed, the community group was able to maintain their present level of functioning and remain living independently in the community. This research also addresses the difficulty in health services research.</td></tr></table>en_GB
dc.date.available2011-10-26T14:08:42Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T14:08:42Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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