Journal of aging & social policy
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Multicenter Study
Provider and care workforce influences on quality of home-care services in England.
A key trend in home care in recent years in England has been movement away from "in-house" service provision by local government authorities (e.g., counties) towards models of service commissioning from independent providers. A national survey in 2003 identified that there were lower levels of satisfaction and perceptions of quality of care among older users of independent providers compared with in-house providers. ⋯ For the most part, characteristics associated with positive perceptions of quality were more prevalent among in-house providers. Multivariate analyses of independent providers suggested that aspects of the workforce itself, in terms of age and experience, provider perceptions of staff turnover, and allowance of travel time, were the most critical influences on service user experiences of service quality.
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As demographic shifts make the Social Security program financially vulnerable, the responsibility for income security in old age will shift from the government to elderly people. In this changing environment, the accumulation of wealth will be a crucial issue because wealth holders can draw income from assets, which can supplement retirement income. ⋯ This article presents the findings of a study of the net worth of elderly people with disabilities. The major findings were that a smaller proportion of elderly people with disabilities has assets of any type compared with elderly people with no disability; the dollar value of each type of asset is smaller among elderly people with disabilities than among elderly people with no disability; and the net worth of people with disabilities is smaller than that of elderly people with no disability even after other variables were controlled.