Journal of aging & social policy
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A commentary of the article discussing the possible reimagining of long-term care (LTC) is provided. The reimagining article examines how to diminish the role of nursing homes in the LTC system. ⋯ It is also thought-provoking. In this commentary I provide a further opinion that we could do better within the current system using the current resources.
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Multicenter Study Comparative Study
Ownership status and home health care performance.
Few studies have analyzed for-profit and nonprofit differences in the home health care sector. Using data from the National Home and Hospice Care Survey, we found that patients in nonprofit agencies were more likely to be discharged within 30 days under Medicare cost-based payment compared to patients in for-profit agencies. However, this difference in length of enrollment did not translate into meaningful differences in discharge outcomes between nonprofit and for-profit patients, suggesting that-under a cost-based payment system-nonprofits may behave more efficiently relative to for-profits. These results highlight the importance of organizational and payment factors in the delivery of home health care services.
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This commentary argues that one-size-fits-all aging in place solutions will often not be in the best interests of low-income and frail older homeowners in the United States. This contrarian view runs counter to the reported preferences of this group, various private-sector activities, and U. ⋯ These vulnerable homeowners would be better served if they relocated to more affordable, easier to maintain, and better designed smaller owned units or rental properties or to planned affordable seniors' rental housing complexes that can offer both light and heavy care. Such residential moves are often not feasible, however, because of the shortage of these housing arrangements.
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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.