Program characteristics and enrollees' outcomes in the Program of All-Inclusive Care for the Elderly (PACE).
The Program of All-Inclusive Care for the Elderly (PACE) is a unique program providing a full spectrum of health care services, from primary to acute to long-term care for frail elderly individuals certified to require nursing home care. The objective of this article is to identify program characteristics associated with better risk-adjusted health outcomes: mortality, functional status, and self-assessed health. The article examines statistical analyses of information combining DataPACE (individual-level clinical data), a survey of direct care staff about team performance, and interviews with management in twenty-three PACE programs. Several program characteristics were associated with better functional outcomes. Fewer were associated with long-term self-assessed health, and only one with mortality. These findings offer strategies that may lead to better care.
Mukamel
Dana B
DB
University of California at Irvine, Center for Health Policy Research, Irvine, CA 92697, USA. dmukamel@uci.edu
Peterson
Derick R
DR
Temkin-Greener
Helena
H
Delavan
Rachel
R
Gross
Diane
D
Kunitz
Stephen J
SJ
Williams
T Franklin
TF
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D017063:Outcome Assessment, Health Care; D016730:Program Development; D014481:United States / Q000453:epidemiology
J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-53
10619316
J Am Geriatr Soc. 2002 Jan;50(1):125-35
12028257
Med Care. 2004 May;42(5):472-81
15083108
Milbank Q. 2004;82(2):257-82
15225330
Int J Qual Health Care. 2004 Aug;16(4):293-301
15252003
J Gerontol A Biol Sci Med Sci. 2006 Jul;61(7):689-93
16870630
J Am Geriatr Soc. 1997 Feb;45(2):223-32
9033525
Health Care Financ Rev. 1998 Spring;19(3):83-100
10345415
N Engl J Med. 1999 Oct 21;341(17):1324-8
10528046
Gerontologist. 2006 Apr;46(2):227-37
16581887
J Am Geriatr Soc. 1975 Oct;23(10):433-41
1159263