Client Satisfaction With Community-Based Services in a Pilot Cost Share–Service Coordination Program

Abstract

The purpose of this research was to measure client satisfaction with community-based services (CBS) in a pilot service coordination-shared cost program. Data were collected with telephone surveys from 307 clients. Instruments with demonstrated reliability and validity were used to measure satisfaction with each of the following CBS: homemaker, home-delivered meals, personal care, transportation, and handyman and/or chore services. Results indicated that on average, clients were satisfied with each of the CBS they received. Gender, income, and level of satisfaction with other CBS were shown to have some influence on satisfaction levels. Community-based services (CBS) are supportive, home-based services that provide functional assistance to frail older persons to enable them to remain safely and comfortably in their homes. CBS for older persons traditionally have been provided by nonprofit agencies in a noncompetitive environment. The Older American's Act provided funding to all persons 60 years and older in need of services regardless of income. Case managers assessed the needs of older persons and matched needs with services on an as-available basis. Older adults had a limited choice of providers, and client satisfaction had a limited influence on service provision. With the aging of the American population, increasing costs of institutionally based care, and the rapidly growing medical home care movement, the supply of and demand for CBS has continued to grow (Florida Demographic Estimating Conference, 1997; U.S. Bureau of the Census, 1996). As a result, CBS are beginning to compete for contracts with Medicare, Medicaid financed diversion projects, and health insurance companies (Riley & Mollica, 1996) and consumers are being asked to share the cost of services (Kisor, 1996). As consumers become

Care Managers as Research Interviewers: A Test of a Strategy for Gathering Consumer Satisfaction Information

“…In addition to the challenges and opportunities posed by using care managers as interviewers, there were several methodological issues related to frail older respondents and to instrument characteristics. There is some evidence that older adults report higher satisfaction with health care services than do younger adults (Jackson & George, 1998) and that women report higher satisfaction than men (Bear & Sauer, 2000). Because the Medicaid waiver population in Ohio is older and predominately female, this is a valid concern for any kind of survey with the PASSPORT population.…”