title: Beneficiary profiles and service consumption patterns in an urban Medicaid home and community-based waiver program.
abstract: The research reported here was conducted as part of a larger program evaluation of an urban Medicaid Home and Community Based-Waiver Program (HCBS). Informed by a secondary analysis of data collected on 723 clients, this article describes the association between client demographics and service consumption patterns among program beneficiaries with emphasis on access to care issues. The majority of the clients were female, African American, nearly 80 years of age, receiving approximately $600 of monthly income. Although White clients on average were higher functioning, they were hospitalized more frequently and took more medications than African American or Hispanic clients. Clients who were bedbound, Hispanic, and most dependent in performing activities of daily living received the fewest "number of services." Clients who suffered the most severe intellectual impairment, living with a spouse, and with the highest incomes received the most "units of service." Interestingly, service usage did not always increase as the client became more dependent in Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), and mobility. The significance of findings is considered in relation to access to care issues.
authors.affiliation: Graduate School of Social Work and Social Research, Bryn Mawr College, 300 Airdale Road, Bryn Mawr, PA 19010, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Davitt
authors.forename: L W
authors.initials: LW
authors.lastname: Kaye
authors.forename: D
authors.initials: D
authors.lastname: Bagati
authors.forename: P
authors.initials: P
authors.lastname: Graub
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006233:Persons with Disabilities; D004608:Eligibility Determination; D005006:Ethnicity; D005260:Female; D016330:Frail Elderly; D006297:Health Services Accessibility; D006699:Home Care Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D015143:Philadelphia; D014481:United States; D014505:Urban Population / Q000145:classification / Q000706:statistics & numerical data*