Allowing Spouses to Be Paid Personal Care Providers: Spouse Availability and Effects on Medicaid-Funded Service Use and Expenditures

Autor/inn/en	Newcomer, Robert J.; Kang, Taewoon; Doty, Pamela
Titel	Allowing Spouses to Be Paid Personal Care Providers: Spouse Availability and Effects on Medicaid-Funded Service Use and Expenditures
Quelle	In: Gerontologist, 52 (2012) 4, S.517-530 (14 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
DOI	10.1093/geront/gnr102
Schlagwörter	Spouses; Caregivers; Nursing Homes; Expenditures; Hospitals; Health Services; Federal Programs; California + Suchen Sie Ihr Suchwort? Ehepartner; Caregiver; Carer; Betreuungsperson; Pfleger; Sonderheim; Ausgaben; Krankengymnast; Krankenhaus; Health service; Gesundheitsdienst; Gesundheitswesen; Kalifornien
Abstract	Purpose of the Study: Medicaid service use and expenditure and quality of care outcomes in California's personal care program known as In-Home Supportive Service (IHSS) are described. Analyses investigated Medicaid expenditures, hospital use, and nursing home stays, comparing recipients who have paid spouse caregivers with those having other relatives or unrelated individuals as their caregivers. Design and Methods: Medicaid claims and IHSS assessment data for calendar year 2005 were linked for IHSS recipients aged 18 years or older (n = 386,447). Results: The rates of ambulatory care-sensitive hospital admissions and Medicaid-covered nursing home placements were at least comparable among IHSS recipients' with spouse, parent, other relative, or nonrelative caregivers. Statistically significant differences reflected more desirable outcomes for those with relatives as paid caregivers. In no comparisons did those with spouse providers have worse outcomes than those with nonrelative providers. Average monthly Medicaid expenditures for all services were also lower for IHSS recipients with family provider. Implications: There were no financial disadvantages and some advantages to Medicaid in terms of lower average Medicaid expenditures and fewer nursing home admissions when using spouses, parents, and other relatives as paid IHSS providers. This argues in favor of honoring the recipient's and family's preference for such providers. (As Provided).
Anmerkungen	Oxford University Press. Great Clarendon Street, Oxford, OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: jnls.cust.serv@oxfordjournals.org; Web site: http://gerontologist.oxfordjournals.org
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10