ELDERLY OUTPATIENT CARE AND INFORMAL SOCIAL SUPPORTS

本研究的目的是探讨 非正式的支持网络和正式的社会支持系统， 在门诊服务的提供上有所收敛。 建议在 在某些情况下，医疗保健系统可以作为社会资源， 向社会和经济资源有限的人提供支助。 审查 根据这一建议，研究计划的重点是那些年龄最大的老年人。 由于社会和经济资源有限， 综合社会服务的环境， 提供门诊护理。 我们有四个具体目标。 1)这项研究将评估 病人的需求和他们的社会资源之间的关系， 未满足的需求造成的痛苦程度。 2)我们将研究 他们的非正式支持和他们的利用之间的关联 卫生和社会服务。 3)研究将确定以下方面的联系： 在非正式和正式网络之间建立这些情况， 正式系统与非正式系统相辅相成， 它取代或弥补了它的不足。 4)这项研究将 还使用民族志方法来探索主观成本和回报 在社会支持过程中。 在这一定性部分， 研究，目标是确定这些支持方面的 可以转移到次要关系的主要关系 在正式的支持系统中。 为了实现这些目标，一个样本的门诊病人，65岁及以上 将从两个门诊诊所抽取，试点研究已经 进行了。 在这些诊所接受服务的老年人人数 有资格获得医疗补助和S.S.I. 许多人还缩短了 社交网络和严重的功能障碍。 两个诊所 将全面的社会服务纳入卫生服务的提供， 在乎 该项目将使用多种方法：审查医疗 记录，重点访谈，标准老年评估工具， 和诊所里的自然观察。

The purpose of this research is to explore associations between the informal support network and the formal social support system as they converge in the delivery of outpatient services. It is proposed that in some cases the health care system may function as a source of social support to those with limited social and economic resources. To examine this proposition, the research plan focuses on those elderly who are most vulnerable because of their limited social and economic resources and those settings which have integrated comprehensive social services in the delivery of outpatient care. Our specific objectives are fourfold. 1) The research will assess the fit between the patients' needs and their social resources and will indentify the level of distress created with unmet needs. 2) We will examine associations between their informal supports and their utilization of health and social services. 3) The research will identify linkages between between the informal and formal network to establish those situations in which the formal system complements the informal system and those in which it substitutes or compensates for its deficiencies. 4) The research will also use ethnographic methods to explore the subjective costs and rewards obtained in the social support process. In this qualitative portion of the research, the objective is to identify those supportive dimensions of primary relationships which can be transferable to secondary relationships in the formal support system. To accomplish these objectives, a sample of outpatients, 65 years and older will be drawn from two outpatient clinics where pilot research has already been conducted. The population of elderly served in these clinics has high proportions who qualify for Medicaid and S.S.I. Many also have abbreviated social networks and high levels of functional impairment. Both clinics have integrated comprehensive social services into the delivery of health care. The project will use a combination of methods: review of medical records, focussed interviews, standard geriatric assessment instruments, and naturalistic observations in the clinics.