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Social Care Services Evidence Summary: Personal Care Services

This evidence summary includes a broad range of research/resources on personal care services and is primarily focused on health 

care impact. It is not intended to be an exhaustive compilation of research/resources on this topic. The information presented in this 

summary can inform the value proposition of partnering with a community-based organization (CBO) or a network of CBOs to offer 

these services and supports as part of a strategy to address social determinants of health (SDOH).

Personal care services (PCS) are services to assist individuals with routine activities, such as bathing and getting in and out of bed. 

PCS support individuals with disabilities and older adults to live in their homes and communities and avoid higher levels of care such 

as nursing homes. There are several promising studies that have linked PCS with improvements in quality of life and health 

outcomes. For example, Cooper et al. (2017) conducted a systematic review of interventions to improve how home caregivers

deliver home care services to older home care clients and found that the interventions that yielded the best results consisted of 

training with additional implementation, such as regular supervision, and promoted care focused around clients’ needs and goals. 

That study also found that caregivers reported valuing need-based work models as opposed to task-based work models. Study 

findings concluded that PCS that are centered around the individual’s needs are beneficial for both the individual and the caregiver. 

Furthermore, Rantz et al. (2011) evaluated Aging in Place (AIP), or living in one’s own home and community safely and 

independently, programs in Missouri and found an increase in health restoration and independence. While cost savings have not 

been established, Counsell et al. (2009) conducted a cost analysis of the Geriatric Resources for Assessment and Care of Elders 

(GRACE) intervention and found that the intervention is relatively cost neutral. The table below highlights specific examples of PCS

interventions and their findings. 

For specific, further detailed information on this evidence, please review the resources listed below.
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Personal Care Services Research and Evidence

Study Population Studied Objective of Study Type of Analysis Findings / Results

Cooper et 

al. (2017)

A systemic review 

evaluating the impact of 

paid home caregiver 

training, supervision, and 

other interventions on 

the health and well-being 

of older home care clients

To improve how 

home caregivers and 

home care agencies 

deliver care to older 

people, regarding 

clients’ health and 

well-being and paid 

caregivers’ wellbeing, job 

satisfaction, and 

retention.

A review of papers found 

in the electronic search 

fitting predetermined 

criteria, assessed quality 

using a checklist, and 

synthesized data using 

quantitative and 

qualitative techniques.

Ten papers described eight interventions. The 

six quantitative evaluations used diverse 

outcomes that precluded meta-analysis. In the 

only quantitative study (a clustered randomized 

control trial), rated higher quality, setting 

meaningful goals, caregiver training, and 

supervision improved client health-related 

quality of life. The interventions that improved 

client outcomes comprised training with

additional implementation, such as regular 

supervision and promoted care focused around 

clients’ needs and goals. In their qualitative 

synthesis of four studies, the intervention 

elements caregivers valued were greater 

flexibility to work to a needs-based rather than 

a task-based model, learning more about 

clients, and improved communication with 

management and other workers.

Counsell at 

al. (2009)

951 low‐income seniors 

aged 65 and older; 474 

participated in the 

intervention and 477 in 

usual care

To provide, from the 

healthcare delivery 

system perspective, 

a cost analysis of the 

GRACE intervention, 

which is effective in 

improving quality of 

care and outcomes.

Randomized control trial

with physicians as the unit 

of randomization; 

measurements included 

chronic and preventive 

care costs, acute care 

costs, and total costs in 

the full sample (n=951) 

and predefined high‐risk 

(n=226) and low‐risk 

(n=725) groups.

Mean 2-year total costs for intervention 

patients were not significantly different from 

those for usual care patients in the full sample. 

In the high-risk group, increases in chronic and 

preventive care costs were offset by reductions 

in acute care costs, and the intervention saved 

costs during the postintervention, or third, year. 

Mean 2-year total costs were higher in the lowrisk group. Overall, in patients at high risk of 

hospitalization, the GRACE intervention is cost 
June 2021 | 3

Study Population Studied Objective of Study Type of Analysis Findings / Results

neutral from the healthcare delivery system 

perspective. 

Dale et al.

(2003)

Included Medicaid 

enrollees who were 

eligible for PCS under the 

Arkansas Medicaid plan 

who enrolled in the 

state’s Independent 

Choices program “Cash 

and Counseling” program,

a model of consumerdirected supportive 

services that gives eligible 

beneficiaries who choose 

to participate a flexible 

monthly allowance to 

purchase disabilityrelated goods and 

services (including hiring 

relatives as workers).

To find the effects of 

Cash and Counseling 

on personal care 

services and 

Medicaid costs in 

Arkansas.

Statistical analysis of 

survey data and Medicaid 

claims data

The program increased the receipt of paid care 

but reduced unpaid care. The treatment group 

had higher Medicaid personal care expenditures 

than controls did, because many controls 

received no paid help, and recipients obtained 

only two-thirds of entitled services. By the 

second year after enrollment, these higher 

personal care expenditures were offset by lower 

spending for nursing homes and other Medicaid 

services.

Rantz et al.

(2011) 

Residents at two long 

term care settings in 

Missouri 

To evaluate AIP as 

an alternative to 

assisted living and 

nursing home care.

Descriptive statistics as 

well as cross-sectional 

and longitudinal analysis

The combined care and housing cost for any 

resident who received care services beyond 

base services of AIP and who qualified for 

nursing home care has never approached or 

exceeded the cost of nursing home care at 

either location. Both mental health and physical 

health measures indicate the health restoration 

and independence effectiveness of the AIP 

model for long-term care.