OUTCOMES AFTER TERMINATION OF MEDICARE HOME HEALTH SERVICES: THEIR RELATIONSHIP TO THE RESOURCES AND WELL-BEING OF ELDERLY CAREGIVING SPOUSES.
Contributors: University of Pennsylvania.
Published: 1986
Number of pages: 232
Subjects: Health Sciences, Nursing.; Gerontology.
Description: The purpose of this study was to determine whether certain outcome events such as death and hospitalization in elderly married couples who had received Medicare-reimbursed home health services were related to caregiving spouses' level of well-being and resources. The research questions raised in this study stemmed from current public policy debate concerning the capability and responsibility of families (versus government-subsidized programs) in caring for chronically ill, aged adults. The research was also designed to address whether the Medicare home health services program is fulfilling its original objectives. These objectives included the prevention of unnecessary institutionalization and death and the improvement of quality of life.

Participation in the study was limited to subjects whose care-receiving spouses had been discharged from Medicare home health agencies in a "stable" or comparable status. Soon after the termination of services, 58 elderly individuals were interviewed regarding their well-being and resources. Two to three months later, the subjects were interviewed again to determine whether specific outcome events had occurred for either member of the couple during the intervening period. These outcomes included death, hospitalization, relocation to a different residence, change in functional status, and change in community-based service utilization.

The data did not reveal that any of the outcomes was significantly related to either the caregiving spouse's level of well-being or resources. However, there was a significant association between the length of time for which caregiving subjects had been providing assistance and the hospitalization of their care-receiving spouses during the follow-up period. Overall, there was a ten percent mortality rate and 20 percent hospitalization rate among care-receiving spouses. Other outcomes occurred with very low frequencies. The Medicare-reimbursed home health care program may be defeating its original goals by compelling clinicians to terminate their services prematurely in the case of certain high-risk clients.
Notes: Source: Dissertation Abstracts International, Volume: 47-07, Section: B, page: 2840.

Thesis (PH.D.)--UNIVERSITY OF PENNSYLVANIA, 1986.

School code: 0175.