Participants in the Program of All-Inclusive Care for the Elderly (PACE) Demonstration

Wieland, Darryl; Lamb, Vicki L.; Wang, Huei; Sutton, Shae R.; Eleazer, G. Paul; Egbert, John

doi:10.1093/geront/40.2.218

Cited by 22 publications

(15 citation statements)

References 4 publications

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“…While there are many success stories, 106 there are also many examples of unintended consequences resulting from changes in how we approach the reimbursement structures for healthcare.…”

Section: Reimbursement Structurementioning

confidence: 99%

“…77 Key differences between the programs reviewed include the year in which the program began, whether an established physician or new physician was involved, the type of setting where it was provided, eligibility for the program, the frequency of contact, and reimbursement structures. 106,[137][138][139] International work has identified other models with promise. [140][141][142][143] Much work is needed in this area, particularly to understand the optimal health systems for younger people with multimorbidity, as well as how to transform typical primary care practices to meet these needs.…”

Section: Approaches Specifically Using a Multimorbidity Perspective Imentioning

confidence: 99%

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Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

2010

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Many people living with chronic conditions have multiple chronic conditions. Multimorbidity is defined here as the co-existence of two or more chronic conditions, where one is not necessarily more central than the others. Multimorbidity affects quality of life, ability to work and employability, disability and mortality. Currently, clinicians have limited guidance or evidence as to how to approach care decisions for such patients. Understanding how to best care and design the health system for patients with multimorbidity may lead to improvements in quality of life, utilization of healthcare, safety, morbidity and mortality. The objective of this paper is to review the implications of multimorbidity for the design of health system and to understand the research needs for this population. The consideration of people with multimorbidity is essential in the design and evaluation of health systems. Fundamentally, people with multimorbidity should receive a patient -and family-centered approach to care throughout the health system, and understanding how to deliver this type of care in effective and efficient ways is an enormous challenge, and opportunity, for clinicians, researchers, and policy makers today.

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“…While there are many success stories, 106 there are also many examples of unintended consequences resulting from changes in how we approach the reimbursement structures for healthcare.…”

Section: Reimbursement Structurementioning

confidence: 99%

Section: Approaches Specifically Using a Multimorbidity Perspective Imentioning

confidence: 99%

Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

2010

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“…More than 12,000 Medicare beneficiaries have been cared for by the PACE model since 1990. A number of recent studies offer a more in‐depth view of PACE 20,23–26 …”

Section: Introductionmentioning

confidence: 99%

Predicting Place of Death in the Program of All‐Inclusive Care for the Elderly (PACE): Participant versus Program Characteristics

Temkin‐Greener

Mukamel

2002

J American Geriatrics Society

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Nationally, the low rate of home death has prompted some to conclude that it is unlikely that we will, as a society, decide to take our dying older people back into our homes. The PACE experience suggests that it is possible to modify this trend. The results indicate that patient and program characteristics are both important in predicting the place of death. The variation across PACE sites suggests that an opportunity for narrowing these gaps, and reducing the proportion of hospital deaths, exists. The PACE end-of-life practice style could potentially be applied to other populations and may have important public policy implications.

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“…The veterans who enrolled in AIC differed from the traditional PACE participant. The veteran population is almost all male, and the majority are married and living with a spouse, whereas the PACE population is predominately female, is not married, and approximately one‐third live alone 15 . The PACE population also has a greater number of enrollees who are severely cognitively impaired.…”

Section: Discussionmentioning

confidence: 99%

Providing All‐Inclusive Care for Frail Elderly Veterans: Evaluation of Three Models of Care

Weaver

Hickey

Hughes

et al. 2008

J American Geriatrics Society

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Frail elderly veterans aged 55 and older who met state nursing home admission criteria were enrolled in one of three models of all-inclusive long-term care (AIC) at three Veterans Affairs (VA) medical centers (n=386). The models included: VA as sole care provider, VA-community partnership with a Program of All-inclusive Care for the Elderly (PACE), and VA as care manager with care provided by PACE. Healthcare use was monitored for 6 months before and 6 to 36 months after enrollment using VA, DataPACE, and Medicare files. Hospital and outpatient care did not differ before and after AIC enrollment. Only 53% of VA sole-provider patients used adult day health care (ADHC), whereas all other patients used ADHC. Nursing home days increased, but permanent institutionalization was low. Thirty percent of participants died; of those still enrolled in AIC, 92% remained in the community. VA successfully implemented three variations of AIC and was able to keep frail elderly veterans in the community. Further research on providing variations of AIC in general is warranted.

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Participants in the Program of All-Inclusive Care for the Elderly (PACE) Demonstration

Cited by 22 publications

References 4 publications

Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

Future of Multimorbidity Research: How Should Understanding of Multimorbidity Inform Health System Design?

Predicting Place of Death in the Program of All‐Inclusive Care for the Elderly (PACE): Participant versus Program Characteristics

Providing All‐Inclusive Care for Frail Elderly Veterans: Evaluation of Three Models of Care

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