From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from…

Dementia appears at a higher rate among some adults with intellectual disabilities (ID) and this potentially poses a greater risk of nursing home admission. Yet, to date, there is no evidence on the efficacy of general dementia-derived environment-, personnel-, and patient-oriented intervention strategies in delaying onset of dementia or in…

The aim of this paper is to measure and to correct for the potential incomparability of responses to the SHARE survey on health care responsiveness. A parametric approach based on the use of anchoring vignettes is applied to cross-sectional data (2006-2007) in eleven European countries. More than 7,000 respondents aged 50 years old and over were…

Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

Background: Aging adults with Down's syndrome (DS) experience more relocations and other life events than adults with intellectual disabilities aged 50 and older without DS. Age-related functional decline and the higher incidence of dementia were implicated as the contributing factors that led to relocation and nursing home placement. Method: A…

Purpose: We compared the rates of specialized care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and examined the associations of SCU residence with process of care and resident outcomes. Design and Methods: Data came from the 2004 National Nursing Home Survey. The indicators of…

The overall use of acute care services by nursing home (NH) residents in Canada has not been well documented. Our objectives were to identify the major causes of hospitalization among NH facility residents and to compare rates to those of community-dwelling seniors. A retrospective cohort was defined using population-level health administrative…

Purpose: A national quality report card for nursing homes, Nursing Home Compare, has been published since 2002. It has been shown to have some, albeit limited, positive impact on quality of care. The objective of this study was to test empirically the hypothesis that nursing homes have responded to the publication of the report by adopting cream…

Examined coping styles and health behaviors of 25 hypertensive patients and 25 normal patients visiting primary care setting for acute medical problems. Hypertensive individuals were more likely to display "high monitoring" (information-seeking) mode of coping than normal individuals, who tended to be "low monitoring" (information avoiding) in…

Purpose: This study had two goals: (a) to assess the validity of the Online Survey Certification and Reporting (OSCAR) staffing data by comparing them to staffing measures from audited Medicaid Cost Reports and (b) to identify systematic differences between facilities that over-report or underreport staffing in the OSCAR. Design and Methods: We…

Analyzes the 1983 distribution of inpatient mental health facilities and estimated inpatient beds for all 3,137 U.S. counties categorized on an 18-position urbanization scale. Finds services available in only 13 percent of all nonmetro counties and in virtually none of the most rural, nonadjacent, nonmetro counties. Contains 30 references. (SV)

To estimate perceived prestige and status attributed to rehabilitation counselors in medical settings 104 physical therapists and occupational therapists compared the social standing of rehabilitation counselors with that of other allied health professionals. Rehabilitation counselors ranked below several other occupational groups, including…

Purpose: Although increased participation in physical activity by older adults is a major public health goal, little is known about the supply and use of physical activity programs in the United States. Design and Methods: Seven academic centers in diverse geographic areas surveyed physical activity programs for older adults. Five sites conducted…

In the early 1990s, a restructuring of the health services system of Alberta (Canada) amalgamated public health units and hospital districts into 17 Regional Health Authorities. Many of the regions have pursued community grant initiatives in addition to their regular funding, and it seemed that there would be value in comparing the experiences of…

Regulations instituted by the Department of Health, Education, and Welfare effective in 1976 require skilled nursing facilities (SNF) to provide either a physician serving as medical director, or to have an organized medical staff. This report describes how SNFs responded, and what the effects were on their operations. Descriptive data were…