Care for Frail Elders: Developing Community Solutions

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Leutz and his colleagues offer the most practice-oriented and realistic assessment of how chronically ill elders are being served at the community level. They analyze options and opportunities open to policy makers and practitioners relative to long-term care in the community environment where so many elders want to be. In the process, the authors evaluate the range of needs, the importance of gender and cultural differences, and the effectiveness of Medicare and Medicaid as entitlement strategies.

Community care constitutes a major gap in the nation's health-care system. The authors show that there are many persuasive reasons to build, staff, manage, and pay for high quality community-care systems. Such programs are demonstrated to be affordable and to meet better the needs of a large percentage of elders who require long-term care. The authors set forth goals for community-care systems and criteria for assessment. This timely analysis, coupled with practical, socially compelling recommendations, responds effectively to the realities of an aging population and the great public policy and related fiscal concerns.


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What Is LongTerm Care and Who Needs It?
State Infrastructure for LongTerm Care Criteria for Adequacy
Understanding and Measuring Quality of Care
Practice and Design Variations in Community Care Management
HomeCare Personnel Issues The Hidden Challenge in Community Care
Aging Differently Issues of Gender and Race
Program Benefits and Costs What We Cover and How We Pay
Social Benefits and Costs Public Responsibility for Community Care and How It Should Be Borne
Private Insurance Models
National Medicaid and Medicare Strategies

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Page 290 - Ethnic differences in the demand for physician and hospital utilization among older adults in major American cities: Conspicuous evidence of considerable inequalities.
Page 286 - HJ (1988). Impact of a geriatric consultation team on discharge placement and repeat hospitalization.
Page 284 - Meiners. MR (1988). Enhancing the market for private long-term care insurance.
Page 283 - A Multidimensional Approach to Case Mix for Home Health Services.

About the author (1992)

Walter N. Leutz is an Associate Research Professor at the Bigel Institute of Health Policy, The Heller School, Brandeis University. He has published Changing Healthcare for an Aging Society.

John A. Capitman is a Research Professor at Bigel Institute and Director, National Aging Resource Center: Long-Term Care.

Margaret MacAdam is Vice President for Community Services at Baycrest in Toronto, Canada.

Ruby Abrahams is a Senior Research Associate at the Bigel Institute. She has published numerous articles on case management and assessment.

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