Can home care services achieve cost savings in long-term care for older people? |
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Authors: | VL Greene J Ondrich S Laditka |
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Affiliation: | Center for Policy Research, Syracuse University, New York, USA. vgreene@maxwell.syr.edu |
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Abstract: | OBJECTIVE: To determine whether efficient allocation of home care services can produce net long-term care cost savings. METHODS: Hazard function analysis and nonlinear mathematical programming. RESULTS: Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. DISCUSSION: Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date. |
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