Impact of Medicare's Prospective Payment System and the Farm Crisis on the Health Care of the Elderly: A Case Study*

Sharp, Tessa S.; Halpert, Burton P.; Breytspraak, Linda M.

doi:10.1111/j.1748-0361.1988.tb00178.x

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…The work of Sharp, Halpert, and Breytspraak (1988) is consistent with this interpretation. Using a more qualitative, personal interview approach, they concluded that among the most significant service gaps in rural Missouri communities were the lack of programs to meet the distinctive needs of terminally ill elders and their families, and the lack of services and programs for the chronically ill older adult.…”

Section: Residential Comparisons In Health Services Utilizationsupporting

confidence: 79%

The Health Status, Health Services Utilization, and Support Networks of the Rural Elderly: A Decade Review*

Dwyer¹,

Lee²,

Coward³

1990

The Journal of Rural Health

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Research from the 1980s on several dimensions of health and health care among the rural elderly is reviewed. Following a brief discussion of the demographic patterns and life conditions of the rural elderly, the current state of knowledge regarding health status, health services utilization, and the potential for informal and familial care of the elderly is examined. The review concentrates on studies that include comparisons between rural and urban populations and/or control for additional variables that are known to covary with residence. Such analyses permit the documentation of the effects of residential location on health indicators net of other factors. The review concludes that the rural elderly are relatively disadvantaged in terms of both health status and access to health care services, and have little if any advantage over the urban elderly in their access to informal sources of care. Following the review, an agenda for future research is identified.

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Section: Residential Comparisons In Health Services Utilizationsupporting

confidence: 79%

The Health Status, Health Services Utilization, and Support Networks of the Rural Elderly: A Decade Review*

Dwyer¹,

Lee²,

Coward³

1990

The Journal of Rural Health

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“…Although most differences in health status between rural and urban elders disappear when other population characteristics are controlled (Cutler & Coward, 1988), disparities in the availability, awareness, and use of formal services persist (Dwyer, Lee, & Coward, 1991). For example, older adults living in rural areas are less likely than those living in urban areas to participate in health promotion activities (Lubben, Weiler, Chi, & DeJong, 1988), to benefit from Title XX social service dollars (Nelson, 1983), and to have access to programs and services designed to meet the needs ofthe most severely impaired older adults (Sharp, Halpert, & Breytspraak, 1988). As a result, rural elders are at risk of entering nursing homes at younger ages and in better health than their urban counterparts (Dwyer et aI., 1994;Greene, 1984).…”

Section: Older Adultsmentioning

confidence: 99%

Caregiving in Social Context

Dwyer

Folts

Rosenberg

1994

Educational Gerontology

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The heterogeneity of family caregiving is explored with specific emphasis on differences by gender, age, race, and area of residence. The aging of the population and other social structural changes during the next several decades will simultaneously increase the size of the population in need of long-term care and constrain the options available to frail elders and their care providers. Research suggests that there will be particularly deleterious consequences for women, older elders, nonwhites, and those who live in rural areas. In addition to these social characteristics, elder abuse and neglect, negative outcomes sometimes associated with caregiving, and the importance of linkages between formal and informal providers are discussed. Finally, the many contributions of older people to society and the fact that most elders are aging well are addressed. The modification of curricula to reflect caregiving in social context will enhance training programs designed for formal and informal providers who work with impaired elders and formal courses available to students in academic institutions. The latter represent future decision makers who will have the opportunity to influence public policies and intervention strategies whose benefits will redound to frail elders and their care providers.

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“…Importantly, Nelson (1980) found that the services that support elderly independence (i.e., namely, day care centers and homemaker services, chore assistance, and meal preparation services) were often the least available to rural eld~ers. Sharp, Halpert, and Breytspraak (1988) identified additional gaps in service provision to the rural elderly to be: (1) lack of services to ease the transition of death for dying patients and their families; (2) lack of education during a hospital stay as to the requirements of the transition to home; and (3) a general lack of supportive services for the chronically ill elderly. Notz (1986) has argued that the lack of availability of social services for the rural elderly is a manifestation of geographical and cultural distance.…”

Section: Migration Patternsmentioning

confidence: 99%