NCJ Number
66118
Journal
GAO Review Volume: 12 Issue: 4 Dated: (FALL 1977) Pages: 16-21
Date Published
1977
Length
6 pages
Annotation
MULTIDIMENSIONAL ANALYSIS IS USED TO ESTIMATE COSTS OF ALTERNATIVES TO INSTITUTIONALIZATION IN CARING FOR THE ELDERLY.
Abstract
A CONGRESSIONAL COMMITTEE ASKED THE GENERAL ACCOUNTING OFFICE TO ANALYZE THE COST OF ALTERNATIVE TYPES OF CARE FOR THE ELDERLY. THE ASSIGNMENT REQUIRED DETERMINING DEGREES OF IMPAIRMENT AND ESTIMATING THE COST OF SERVICES PROVIDED BY FAMILY AND FRIENDS. THIS NECESSITATED AN EXAMINATION OF DEGREES AND LEVELS OF FUNCTIONING IN AN ELDERLY SAMPLE AND ASCERTAINING THE KINDS OF SERVICES NEEDED FOR THE SUBJECTS IN VARIOUS CATEGORIES OF IMPAIRMENT. A TOTAL OF 1,609 SUBJECTS WERE RATED IN EACH OF FIVE DIMENSIONS, BASED ON QUESTIONNAIRE RESULTS: SOCIAL AND ECONOMIC STATUS, MENTAL AND PHYSICAL HEALTH, AND ABILITY TO DO DAILY TASKS. USING COMBINATIONS OF THE 28 SERVICES AVAILABLE IN CLEVELAND, THE STUDY SITE, SERVICE PACKAGES WERE DEVELOPED FOR EACH IMPAIRMENT LEVEL USING COMPUTER CROSS-TABULATIONS. ALSO DETERMINED WERE THE PERCENT OF THE SUBJECTS RECEIVING EACH SERVICE, THE PERCENT RECEIVING EACH SERVICE FROM FAMILY AND FRIENDS, THE NUMBER RECEIVING EACH SERVICE FROM AN AGENCY, AND THE AVERAGE MONTHLY FREQUENCY OF USE OF EACH SERVICE. COST DATA FOR EACH SERVICE WERE OBTAINED FROM INTERVIEWS WITH REPRESENTATIVES OF LOCAL AGENCIES SERVING THE ELDERLY. AGENCY COSTS AND COSTS TO FAMILY AND FRIENDS FOR EACH SERVICE AT EACH IMPAIRMENT LEVEL WERE ESTIMATED IN TERMS OF MONTHLY COST PER 1,000 PEOPLE. A COMPARISON OF IN-HOME SERVICE COSTS WITH INSTITUTIONAL COSTS SHOWED THAT HOME SERVICES COST MORE AT THE HIGHER IMPAIRMENT LEVELS. ALTHOUGH THE BREAK-EVEN POINT FALLS WITHIN THE GREATLY IMPAIRED LEVEL, ABOUT 14 PERCENT OF UNINSTITUTIONALIZED ELDERLY ARE PAST THIS POINT. GRAPHIC DATA ARE PROVIDED. (RCB)