Kane Robert L, Homyak Patty, Bershadsky Boris
Division of Health Services Research and Policy, University of Minnesota School of Public Health, Minneapolis 55455, USA.
Gerontologist. 2002 Jun;42(3):314-20. doi: 10.1093/geront/42.3.314.
To compare enrollees in the Wisconsin Partnership Program (WPP), a Program for All-inclusive Care of the Elderly (PACE) variant designed to allow clients to use their regular primary care physician, with PACE enrollees in two programs operated by the two Wisconsin agencies.
All enrollees in both programs were included in the sample. Enrollees were interviewed in person. Family members were interviewed by telephone. Questions compared disability levels and satisfaction.
The WPP clients were generally less disabled than the PACE enrollees. The levels of satisfaction among both clients and family members were essentially comparable. The use of advance directives was higher than in the general population but did not differ across the programs.
WPP may be a valuable alternative to the rigid PACE approach, which may make enrollment difficult. However, a problem may lie in the limited participation of physicians. On average, the primary care physicians had only about six clients each. This level of involvement is insufficient to motivate them to change their practice patterns to accommodate this more comprehensive and integrated approach of care of frail older persons.
比较威斯康星伙伴计划(WPP)的参与者与威斯康星州两个机构运营的两个项目中的PACE参与者。WPP是一种老年人全包式护理计划(PACE)的变体,旨在让客户能够使用他们的常规初级保健医生。
两个项目的所有参与者都纳入样本。对参与者进行了面对面访谈。通过电话对家庭成员进行了访谈。问题涉及残疾水平和满意度比较。
WPP客户的残疾程度总体上低于PACE参与者。客户和家庭成员的满意度水平基本相当。预先指示的使用率高于普通人群,但各项目之间没有差异。
WPP可能是严格的PACE方法的一个有价值的替代方案,后者可能使参保变得困难。然而,一个问题可能在于医生的参与有限。平均而言,每位初级保健医生只有大约六位客户。这种参与程度不足以激励他们改变执业模式以适应这种针对体弱老年人的更全面、综合的护理方法。