[Adult day care in the USA]

This travel report describes the supply of the USA with adult day care centers and it wants to enable a comparison with the situation in other countries. The US situation is characterized by a great number of centers, most of which are not day hospitals but day care centers. The spectrum of services offered is rather big with a great diversification. Financing and organising of transport service is a great problem in many an institution. A great part of the American population has no health insurance. For patients of 65 and over, medicare, a federal program will take over the cost for treatment. Regulations of medicare are similar to the right of German health insurance: health insurance will pay for people in need of treatment, patients who are just in need of maintenance therapy or care will have to pay for themselves. Medicaid, a federal welfare program, will only pay for them, if they cannot afford the money. If medicare would pay for day treatment in general, a rise in the number of day care centers and day hospitals could be expected. There are only rudiments for cost-benefit-analysis in day care in existence. Four centers in different states were described in detail.