What works? Maine's statewide uniform assessment and home care planning system tells all.
What works? Maine's statewide uniform assessment and home care planning system tells all.
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DOI：
10.1093/geront/41.3.309
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
L. Olsen
中科院分区：
文献类型：
--
作者：
C. Gianopoulos;E. Bolda;M. Baldwin;L. Olsen
缅因州的国家资助的家庭护理（HBC）计划成功地调整资源与消费者的护理需求。缅因州HBC计划利用训练有素的护士评估员制定和授权服务计划，将家庭护理服务目标对准那些最需要的人。最近对该计划的分析发现，授权服务计划的成本持续增加，并与减值水平呈线性关系。从国家政策的角度来看，这一发现为制定政策提供了基础，这些政策可以更公平地将有限的国家资助的家庭和社区资源分配给最需要护理的人。Weissert、Cready和Pavelak（1988）在对27项以家庭和社区为基础的护理服务研究进行的荟萃分析中得出结论，以家庭和社区为基础的资源没有充分针对最需要的人。由于资源未能与需求相匹配，再加上家庭保健支出的增长，国家决策者不得不努力解决“如何在公平的基础上提供所需的服务，并以这样一种方式提供服务，即家庭护理人员不会试图用公共资助的护理来取代他们长期提供的护理”（哈德逊，1996年，第456页）。虽然病例组合分类系统（Fries & Cooney，1985年）和支付方法已经开发出来，以确定和分配资源的护理设施，家庭护理需要与资源要求的方法仍然相对未知。
Maine’s state-funded home-based care (HBC) program succeeds in aligning resources with the care needs of consumers. Using trained nurse assessors who develop and authorize service plans, the Maine HBC program targets home care services to those most in need. A recent analysis of the program found that authorized service plan costs increased consistently and in a linear relationship with levels of impairment. From a state policy perspective, this finding provides a basis for developing policies that more equitably distribute limited state-funded home- and community-based resources to those most in need of care. Background In their meta-analysis of 27 home- and community-based care service studies, Weissert, Cready, and Pavelak (1988) concluded that home- and community-based resources are not adequately targeted to those in greatest need. This failure to align resources with need, combined with the growth in home health expenditures, leaves state policy makers struggling with “how to provide needed services on an equitable basis and do so in such a manner that family caregivers do not try to substitute publicly-funded [sic] care for the care they have been long providing” (Hudson, 1996, p. 456). Although case mix classification systems (Fries & Cooney, 1985) and payment methods have been developed to identify and allocate resources in nursing facilities, methods for aligning home care need with resource requirements remain relatively unknown.