Home Health Care

This research examines the concept of home health care (HHC) services delivery for the elderly. HHC is examined as an alternative to institutional delivery of health care services. The focus in this examination is on the delivery of longterm care (LTC) to chronically ill individuals.

HEALTH CARE NEEDS AND COSTS OF THE ELDERLY

The average life span in the United States increased from an expected 70 years in 1960 to 79 years in the late 1980s. The expected life span for women is greater than that for men. Additionally, the expected life span applied to individuals born in the year for which the statistic is determinednot for those individuals already in their elderly years. A similar life expectancy increase, however, developed with respect to all age groups in the American population.

Between 1970 and 1980, the total population of the United States grew by 11.3 percent (Paxton, 1988). That segment of the population aged 65 years old or older increased by 27.5 percent (U.S. Department of Commerce, Bureau of the Census, 1986). Thus, the problems and costs associated with the delivery of health care services to the elderly in the United States will likely increase in the future, during the remaining years of the twentieth century.

Advances in medical technology radically changed many treatments in the 1970s and 1980s. While the quality level of health care improved as a result of these technological advances, the cost

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4 million elderly Americans live in nursing homes. The remaining 11.5 million elderly individuals who receive LTC at some time during any given year receive these services in (1) shortterm longterm care (STLTC) facilities, which provide less intense levels of care than that provided by nursing homes, (2) skilled nursing facilities (SNF), which provide for extended care following hospital discharge, and (3) in the home (Minahan, 1988a). The delivery of LTC to the elderly in their homes is provided for under Title XX of the Social Security Act, and under Title III of the Older Americans Act. Title XX of the Social Security Act provides LTC recipients with homemaking and handyman services. Title XX services are funded by the federal government. The services may be provided in a variety of ways: (1) directly by municipal employees; (2) contracted out to home health agencies; or (3) vouchers provided to LTC recipients, which may be used for direct payment to homemaker and handyman services deliverers (Minahan, 1988b). Services provided to LTC recipients under Title III of the Older Americans Act are also funded by the federal government. The actual services are delivered by contract agencies. The primary services whic

Category: Medical - H