Journal Article

Medicaid Home Care Services and Survival in New York City

Steven M. Albert, Bridget Simone, Andrea Brassard, Yaakov Stern and Richard Mayeux

in The Gerontologist

Published on behalf of The Gerontological Society of America

Volume 45, issue 5, pages 609-616
Published in print October 2005 | ISSN: 0016-9013
Published online October 2005 | e-ISSN: 1758-5341 | DOI: http://dx.doi.org/10.1093/geront/45.5.609
Medicaid Home Care Services and Survival in New York City

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Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid Home Care Services Program were merged with epidemiologic and diagnostic data collected in a community study of older adults living in northern Manhattan. Of 866 older adults with Medicaid coverage living in the community, 288 (33.3%) received Medicaid home care services in the period from 1994 to 1996. Mortality was tracked through the end of 1999. Results: In proportional hazards models that adjusted for differences in sociodemographic, medical, and functional status, use of Medicaid home care service was associated with a significantly reduced risk of death in people with disability in activities of daily living. Implications: Because the program has distinctive features (greater number of weekly hours than other programs, integration with nursing assessments), it is a special case of community-based long-term care. Still, results from this observational cohort suggest that mortality risk in the most vulnerable elderly population can be reduced through a program of supportive care.

Keywords: Survival; Home attendant care; Medicaid; Population-based study; Dementia

Journal Article.  5570 words.  Illustrated.

Subjects: Geriatric Medicine ; Biological Sciences ; Psychology ; Gerontology and Ageing

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