title: The past and future of home- and community-based long-term care.
abstract: For almost three decades researchers have sought to quantify the benefits of home and community care for the elderly, invariably assuming that such care would be an economical substitute for institutionalization. Twenty-seven studies that met rigorous criteria of design, size, and subject were analyzed and the results were synthesized to address the effects on institutional utilization and expenditures, and patient health status and well-being. Home- and community-based health care services are shown to raise overall utilization and costs. Health status effects are limited primarily to patient and caregiver contentment and reduction of unmet needs. Recommendations are made for reaping this considerable benefit more efficiently.
mesh_terms: D000368:Aged; D003153:Community Health Services / Q000191:economics*; D003363:Cost Control; D006302:Health Services Research; D006304:Health Status; D006699:Home Care Services / Q000191:economics*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D008134:Long-Term Care / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000706:statistics & numerical data; D014481:United States