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The Effect of Construction and Demolition Waste Plastic Fractions on Wood-Polymer Composite Properties

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The woodwork effect: estimating it and controlling the damage.

William G Weissert¹, Lucy Frederick

¹Department of Political Science, Faculty Associate, Pepper Institute on Aging and Public Policy, Director, Masters of Public Health Degree Program, Florida State University, Tallahassee, Florida 32306, USA. wweissert@fsu.edu

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|April 11, 2013

Summary

Home- and community-based services (HCBS) attract younger, healthier individuals. While HCBS slightly reduce nursing home use, the effect is minimal and doesn't justify the costs, with little impact on adverse outcomes.

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Area of Science:

Gerontology
Health Services Research
Public Health Policy

Background:

Home- and community-based services (HCBS) are an alternative to institutional care.
The patient population utilizing HCBS differs significantly from those typically admitted to nursing homes.
Understanding the true impact of HCBS on nursing home utilization and patient outcomes is crucial for policy and resource allocation.

Purpose of the Study:

To evaluate the actual impact of HCBS on nursing home admission rates.
To assess the effect of HCBS on adverse patient outcomes.
To determine if the benefits of HCBS, in terms of reduced nursing home use and improved outcomes, justify their costs.

Main Methods:

Systematic review and meta-analysis of 43 studies on HCBS and nursing home utilization.
Analysis of patient characteristics in HCBS versus traditional nursing home populations.
Comparison of nursing home admission rates and adverse outcomes between HCBS recipients and control groups.

Main Results:

Patients attracted to HCBS are generally younger, less dependent, and more mentally intact than nursing home residents.
Only a small fraction of individuals identified as at-risk for nursing home admission actually transition, even without HCBS.
HCBS demonstrated a statistically small reduction in nursing home use, insufficient to offset program costs.
Minimal to insignificant effects were observed on most adverse patient outcomes.

Conclusions:

The current evidence suggests that HCBS do not significantly decrease nursing home utilization or improve adverse outcomes to a degree that justifies their expenditure.
The patient profile in HCBS indicates a population that may not have otherwise required institutionalization.
Further research is needed to identify specific HCBS interventions that yield more substantial positive impacts on patient outcomes and cost-effectiveness.