title: Impact of Medicare's prospective payment system and the farm crisis on the health care of the elderly: a case study.
abstract: The spectrum of health care for the rural elderly has been negatively affected by recent changes in Medicare reimbursement policies and by the farm crisis. This case study examined the effects of these changes on the ability of rural hospitals, the aging network, and care-givers to provide adequate and continuous care to the elderly. In this case study, three gaps in services were found: a lack of programs designed to meet the needs of terminally ill patients and their families; a lack of education during the crucial transitional period between hospital discharge and home; and a lack of services and programs for the chronically-ill older adult. More studies are needed to determine if similar service gaps will be found in other rural communities. If so, public attention should be focused on possible solutions.
mesh_terms: D000368:Aged; D000383:Agriculture / Q000191:economics*; D003266:Continuity of Patient Care; D003710:Demography; D006299:Health Services for the Aged / Q000191:economics*; D006701:Home Nursing / Q000191:economics; D006780:Hospitals, Rural / Q000191:economics; D006801:Humans; D007407:Interviews as Topic; D006278:Medicare; D008923:Missouri; D011445:Prospective Payment System; D011635:Public Health Administration / Q000191:economics; D012423:Rural Health / Q000639:trends*