International Journal of Gerontology
Volume 2, Issue 4 , Pages 167-171, December 2008

Integrated Care for the Elderly in the Community

  • Hong-Ting Chan

      Affiliations

    • Department of Neurology, Puli Christian Hospital, Nantou, Taiwan
    • Graduate Institute of Health Policy and Management, National Taiwan University, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Hong-Ting Chan, Department of Neurology, Puli Christian Hospital, 1, Tieshan Road, Puli, Nantou, Taiwan
  • ,
  • Shih-Jung Cheng

      Affiliations

    • Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan
  • ,
  • Hwei-Jeh Su

      Affiliations

    • Department of Otolaryngology, Puli Christian Hospital, Nanton, Taiwan

Accepted 24 October 2008.

Article Outline

SUMMARY 

Care of the elderly, particularly the frail, poses a challenge to current health care systems. There is increasing interest in the ability of integrated care models to permit the elderly to remain in their communities, to improve health, satisfaction, and service utilization outcomes. We introduce an innovative long-term care model based on the model created in the early seventies by the Chinese American community in San Francisco to care for its elders in a community setting.

Key Words:  aging , community health services , community networks , health services for the aged , integrated delivery of health care

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Peace S , Holland C . Homely residential care: a contraction in terms? . J Soc Policy . 2001;30:393–410
  2. Keating NC , Fast JE , Connidis IA , Penning M , Keefe J . Bridging policy and research in eldercare . Can J Aging . 1997;16:22–41
  3. Kemper P , Applebaum R , Harrigan M . Community care demonstrations: what have we learned? . Health Care Financ Rev . 1987;8:87–100
  4. Newman S , Envall K . The effects of supports on sustaining older disabled persons in the community . Washington, DC: AARP; 1995;
  5. Doty P . Cost-effectiveness of home and communitybased long-term care services . Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Policy and Evaluation, Aging and Long-Term Care Policy; 2000;
  6. Bergman H , Beland F , Lebel P , Contandriopoulos AP , Tousignant P , Brunelle Y , et al.   Care for Canada's frail elderly population: fragmentation or integration? . CMAJ . 1997;157:1116–1121
  7. Hirschfeld MJ . Demography is destiny: the growing international need for home care services . Caring . 2004;23:6–9
  8. Clemens E , Wetle T , Feltes M , Crabtree B , Dubitzky D . Contradictions in case management: client-centered theory and directive practice with frail elderly . J Aging Health . 1994;6:70–88
  9. Calhoun C . Community without propinquity revisited: communications technology revisited and the transformation of the urban public space . Sociol Inq . 1998;68:373–397
  10. Gilleard C , Hyde M , Higgs D . The impact of age, place, aging in place, and attachment to place on the wellbeing of the over 50s in England . Res Aging . 2007;29:590
  11. Wu SC , Chuang KY . Aging in place: the direction of Taiwan long-term care policy in 21st century . Taiwan J Public Health . 2001;20:192–201
  12. Li IC , Yin TJC . Care needs of residents in communitybased long-term care facilities in Taiwan . J Clin Nurs . 2005;14:711–718
  13. Hennessy P . Caring for Frail Elderly People: Policies in Evolution. Social Policy Studies No. 19 . Paris: OECD; 1996;
  14. Wu SC , Chuang KY , Chen LJ . Pilot program for the development of long-term care system: demands and out-ofpocket expenses in experimental communities prior to intervention . Taiwan J Public Health . 2004;23:209–220
  15. The Executive Yuan. Development Vision for 2015 FirstStage Three-Year Sprint Program (2007–2009), February 6, 2007. Available at: http://www.cepd.gov.tw/encontent/m1.aspx?sNo=0007382&ex=1&ic=0000069 [Date accessed: 20 May 2008]
  16. Davies B . The reform of community and long-term care of elderly persons: an international perspective . In:  Scharf T ,  Wenger CC editor. International Perspectives on Community Care for Older People . Brookfield, VT: Ashgate; 1995;p. 21–38
  17. Vladeck BC . Overall perspectives . In:  Wiener JM ,  Clauser SB ,  Kennell DL editor. Persons with Disabilities: Issues in Health Care Financing and Service Delivery . Washington, DC: Brookings Institution; 1995;p. 19–28
  18. Leutz WN . Five laws for integrating medical and social services: lessons from the United States and the United Kingdom . Milbank Q . 1999;77:77–110
  19. Johri M , Beland F , Bergman H . International experiments in integrated care for the elderly: a synthesis of the evidence . Int J Geriatr Psychiatry . 2003;18:222–235
  20. Béland F , Bergman H , Lebel P , Clarfield AM , Tousignant P , Contandriopoulos AP , et al.   A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial . J Gerontol A Biol Sci Med Sci . 2006;61:367–373
  21. Billing J , Leichsenring K . Integrating Health And Social Care Services for Older Persons: Evidence from Nine European Countries . Aldershot: Ashgate Publishing; 2005;
  22. Wieland D , Lamb VL , Sutton SR , Boland R , Clark M , Friedman S , et al.   Hospitalization in the Program of All-Inclusive Care for the Elderly (PACE): rates, concomitants, and predictors . J Am Geriatr Soc . 2000;48:1373–1380
  23. Kane RL , Kane RA , Finch M , Harrington C , Newcomer R , Miller N , et al.   S/HMOs, the second generation: building on the experience of the first Social Health Maintenance Organization demonstrations . J Am Geriatr Soc . 1997;45:101–107
  24. Robinson JC . The end of managed care . JAMA . 2001;285:2622–2628
  25. Ansak M . The On Lok Model: consolidating care and financing . Generations . 1990;14:73–74
  26. Kane RL . Setting the PACE in chronic care . Contemp Gerontol . 1999;6:47–50
  27. Eleazer P, Fretwell M. The PACE model: a review. In: Katz P, Kane RL, Mezey M, eds. Advances in Long-term Care, Volume 4, 1999.
  28. Eng C , Pedulla J , Eleazer GP , McCann R , Fox N . Program of All-inclusive Care for the Elderly (PACE): an innovative model of integrated geriatric care and financing . J Am Geriatr Soc . 1997;45:223–232
  29. Gross DL , Temkin-Greener H , Kunitz S , Mukamel DB . The growing pains of integrated health care for the elderly: lessons from the expansion of PACE . Milbank Q . 2004;82:257–282
  30. Bodenheimer T . Long-term care for frail elderly people: the On Lok Model . New Engl J Med . 1999;341:1324–1328
  31. Temkin-Greener H , Mukamel DB . Predicting place of death in the program of all-inclusive care for the elderly (PACE): participant versus program characteristics . J Am Geriatr Soc . 2002;50:125–135
  32. National PACE Association  . PACE Census and Capitation Rate Information. Alexandria, VA, 2006 . Available at: http://www.npaonline.org/website/download.asp?id=2301 [Date accessed: 7 July 2008]

PII: S1873-9598(09)70005-5

doi:10.1016/S1873-9598(09)70005-5

International Journal of Gerontology
Volume 2, Issue 4 , Pages 167-171, December 2008