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Medicalization, public policy and the elderly: social services in jeopardy?
E A Binney1, C L Estes, S R Ingman
1Department of Social and Behavioral Sciences, University of California, San Francisco 94143.
Social Science & Medicine (1982)
|January 1, 1990
Summary
Community-based elderly services are becoming more medicalized, reducing social support. Home health agencies (HHAs) prioritize medical care over requested social services due to policy changes.
Area of Science:
- Gerontology
- Health Services Research
- Public Policy
Background:
- Community-based services for the elderly are undergoing medicalization.
- This shift prioritizes highly medical services for frail older adults.
- It occurs at the expense of broader social and supportive services for diverse needs.
Purpose of the Study:
- To examine the medicalization of community-based elderly services.
- To understand the impact of government policy, particularly Medicare reimbursement, on service provision.
- To analyze the consequences for social and supportive care.
Main Methods:
- Utilized data from the DRG Impact Study (1986-1987).
- Conducted telephone interviews with directors of a representative sample of home health agencies (HHAs).
- Analyzed data on services, policy impact, and staffing.
Main Results:
- Home health agencies (HHAs) were more likely to add highly medical services.
- HHAs reported social/supportive services as the most requested services they could not provide.
- Increased competition in the health and social service sector was noted.
Conclusions:
- Government policy changes, especially Medicare reimbursement, drive the medicalization of elderly care.
- This trend leads to a reduction in essential social and supportive services.
- The medicalization of home care has significant policy and societal implications.