Felix Holly C, Stewart M Kathryn, Mays Glen P, Cottoms Naomi, Olson Mary K, Sanderson Herb
University of Arkansas for Medical Sciences, USA.
Prog Community Health Partnersh. 2007 Winter;1(4):311-9. doi: 10.1353/cpr.2007.0043.
Long-term care (LTC) is a major health policy issue owing to increasing LTC expenditures and the anticipated growth in the aging population. However, accessing LTC services, especially home- and community-based LTC services, is often difficult.
This manuscript describes the Community Connector Program, the first known program to use a model in which community health workers (CHWs) help to connect adults in need of LTC to such services. We examine the community-university-government agency partnership created to implement and evaluate the program, summarize the evaluation design, and provide first-year implementation results.
Descriptive statistics were used to characterize persons served and services to which persons were connected. The quasi-experimental evaluation design, which is planned to estimate the program's impact on LTC service utilization and costs within the Arkansas Medicaid program, is described.
Community Connectors linked 686 persons (92% > or =18 years, 80% African American, 58% female) to at least one needed service. Only 39% of adults served needed LTC based on an LTC screening tool. Nearly all (93%) adults in need of LTC had health insurance; 53% had Medicare; 37%, both Medicare and Medicaid; and 11%, Medicaid. Community Connectors referred adults in need of LTC to 68 agencies and helped them to connect to services to address an average of two needs per adult.
Preliminary results from the first-year implementation evaluation indicate the program is effective in linking persons to needed LTC, although program refinements were made to improve targeting of intended program recipients.
由于长期护理（LTC）支出不断增加以及老年人口预期增长，长期护理成为一个主要的卫生政策问题。然而，获得长期护理服务，尤其是居家和社区长期护理服务，往往很困难。
本论文描述了社区连接者项目，这是首个已知的使用社区卫生工作者（CHWs）帮助将需要长期护理的成年人与此类服务相连接的模式的项目。我们研究了为实施和评估该项目而建立的社区-大学-政府机构合作伙伴关系，总结了评估设计，并提供了第一年的实施结果。
使用描述性统计来描述所服务的人群以及他们所连接的服务。描述了拟用于估计该项目对阿肯色州医疗补助计划内长期护理服务利用和成本影响的准实验评估设计。
社区连接者将686人（92%年龄≥18岁，80%为非裔美国人，58%为女性）与至少一项所需服务相连接。根据长期护理筛查工具，只有39%接受服务的成年人需要长期护理。几乎所有（93%）需要长期护理的成年人都有医疗保险；53%有医疗保险；37%同时拥有医疗保险和医疗补助；11%只有医疗补助。社区连接者将需要长期护理的成年人转介到68个机构，并帮助他们连接到服务，以满足每位成年人平均两项需求。
第一年实施评估的初步结果表明，该项目在将人们与所需的长期护理相连接方面是有效的，尽管对项目进行了改进以提高目标项目接受者的针对性。
