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Long-term care and AIDS: perspectives from experience with the elderly.
1University of California, San Francisco.
The Milbank Quarterly
|January 1, 1988
Summary
Policy shifts for the elderly and AIDS patients focused on cost containment through community care. However, this approach increased overall service utilization and expenditures, failing to reduce institutional care costs.
Area of Science:
- Health Policy
- Geriatric Care
- Public Health
Background:
- Cost containment is a primary driver in healthcare policy for both elderly and Acquired Immunodeficiency Syndrome (AIDS) patients.
- Community-based services are often favored to reduce hospital and nursing home stays, aiming to meet patient needs and control expenses.
Purpose of the Study:
- To evaluate the impact of community-based service expansion on healthcare utilization and costs for the elderly.
- To analyze the effectiveness of community care models for Acquired Immunodeficiency Syndrome (AIDS) patients in relation to medical management and hospitalization.
Main Methods:
- Comparative analysis of healthcare utilization and expenditure data for elderly populations receiving community-based services.
- Review of policy assumptions regarding community care for AIDS patients versus the realities of medical management.
Main Results:
- For the elderly, community services showed minimal impact on institutional care use, offered limited outcome benefits, and increased overall service utilization and costs.
- The focus on community care for AIDS patients overlooks the critical role of intensive medical care in disease management.
Conclusions:
- Policies prioritizing community care over institutional settings for the elderly have not proven cost-effective and may increase overall healthcare expenditure.
- Relying on community care for AIDS patients without acknowledging the necessity of comprehensive medical interventions may be detrimental to patient outcomes and cost management.