The Gerontologist
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Alkema, G. E.
Right arrow Articles by Wilber, K. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Alkema, G. E.
Right arrow Articles by Wilber, K. H.
The Gerontologist 46:173-182 (2006)
© 2006 The Gerontological Society of America

Characteristics Associated With Home- and Community-Based Service Utilization for Medicare Managed Care Consumers

Gretchen E. Alkema, MSW, LCSW1, Judy Y. Reyes, PhD2 and Kathleen H. Wilber, PhD2

Correspondence: Address correspondence to Gretchen E. Alkema, MSW, LCSW, Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Ave., Los Angeles, CA 90089-0191. E-mail: alkema{at}usc.edu

Purpose: We identified the types of home- and community-based services (HCBS) that high-risk older adults in Medicare managed care used, and we examined participant characteristics associated with service use in six areas: overall service use, four specific categories of HCBS, and referrals to insured medical services. Design and Methods: We used service data from the Care Advocate Demonstration Program, a telephone-based care-management intervention that linked chronically ill older adults to HCBS. Two hundred and twenty-four high-risk older adults who were enrolled in a southern California-based Medicare managed care plan received an assessment, service referrals, and 12 months of telephone follow-up by master's level social service professionals. We used logistic regression to estimate the odds of using the HCBS categories and medical services. Results: Results indicated that characteristics associated with service use varied extensively, depending on the service. Age, gender, social support, living situation, education, specific functional impairments, heart conditions, and sensory impairments at baseline significantly predicted utilization in the six different service models. Implications: Policy implications include the importance of individualized care-management assessments that direct targeted referrals to appropriate services. Findings support the need for individualized care-management assessment and service planning, suggesting that a "one size fits all" approach to HCBS will not meet the varied needs of diverse consumers.

Key Words: Home- and community-based services • Medicare managed care • Service utilization • Case management • Chronic care




This article has been cited by other articles:


Home page
J Transcult NursHome page
J. D. Crist, Seon Hye Woo, and M. Choi
A Comparison of the Use of Home Care Services by Anglo-American and Mexican American Elders
J Transcult Nurs, October 1, 2007; 18(4): 339 - 348.
[Abstract] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
All GSA journals Journals of Gerontology Series A: Biological Sciences and Medical Sciences Journals of Gerontology Series B: Psychological Sciences and Social Sciences
Copyright © 2006 by The Gerontological Society of America.