Synthesis of research on the costs of institutional and community-based care.
Cost studies in the long-term care field are reviewed, with emphasis on those relating to people with developmental disabilities. Studies frequently stressed the cost-effectiveness of community programs but often had significant methodological problems. Among the predominant findings in the literature were: 1) the generally lower average costs per client in community programs versus institutional programs; 2) unexplained wide cost ranges in similar community programs; and 3) significant cost shifts among federal, state, and local governments associated with deinstitutionalization initiatives. The implications of these findings for public officials and the advocacy community are discussed.
Mitchell
D
D
School of Public Health, University of Illinois at Chicago 60608.
Braddock
D
D
Hemp
R
R
D003156:Community Mental Health Services / Q000191:economics*; D003365:Costs and Cost Analysis; D003688:Deinstitutionalization; D006076:Government; D006302:Health Services Research; D007326:Institutionalization / Q000191:economics*; D014481:United States