Organizational characteristics, client characteristics, and the delivery of home care services

This research examines the extent to which organizational professional orientation, client perceived needs, and client characteristics jointly determine long-term care service delivery to a frail elderly population. The study uses primary data collected from 16 community networks that were part of a national demonstration of the Living at Home Program, conducted from 1986 to 1989. Data include baseline assessments of individuals enrolled at each site, subsequent utilization data, and data on community network characteristics. Site professional orientation has a significant role in determining services provided to clients, with social service agencies more likely to provide nonmedical services and less likely to provide skilled-care services. Despite systematic site variation in the services provided to individuals, sites appear to reasonably allocate resources among individuals with differing levels of functional disability.