Robison Julie, Porter Martha, Shugrue Noreen, Kleppinger Alison, Lambert Dawn
Julie Robison (
Martha Porter is a research associate in the Center on Aging at UConn Health.
Health Aff (Millwood). 2015 Oct;34(10):1628-36. doi: 10.1377/hlthaff.2015.0244.
A centerpiece of federal and state efforts to rebalance long-term services and supports to enhance consumer choice and contain costs, the federal Money Follows the Person Rebalancing Demonstration helps qualified individuals living in institutions make the transition to life in the community. The Connecticut Money Follows the Person program is an unusually rich source of data, with information on the 2,262 people who transitioned to the community under that state's program during 2008-14. Responses to participant surveys completed before and six, twelve, and twenty-four months after transition indicate that, for the majority of respondents who remained in the community, quality of life and life satisfaction improved significantly after transition, and they stayed high. About half of the participants visited hospitals or emergency departments after transition; however, only 14 percent had returned to an institution one year after transition. Predictors of reinstitutionalization included some not previously observed: mental health disability, difficulties with family members before transition, and not exercising choice and control in daily life. These and other findings suggest multiple ways in which policy makers can target efforts to strengthen transition programs that can meaningfully improve people's lives while containing costs.
作为联邦和州政府为重新平衡长期服务与支持以增强消费者选择并控制成本所做努力的核心内容，联邦“资金跟随个人”再平衡示范项目帮助居住在机构中的符合条件的个人向社区生活过渡。康涅狄格州的“资金跟随个人”项目是一个极为丰富的数据来源，包含了2008年至2014年期间该州项目下向社区过渡的2262人的信息。对参与者在过渡前以及过渡后六个月、十二个月和二十四个月完成的调查的回复表明，对于大多数留在社区的受访者来说，生活质量和生活满意度在过渡后显著提高，并且一直保持在较高水平。约一半的参与者在过渡后去过医院或急诊室；然而，只有14%的人在过渡一年后回到了机构。重新入住机构的预测因素包括一些此前未观察到的因素：精神健康残疾、过渡前与家庭成员的矛盾以及在日常生活中缺乏选择和控制权。这些以及其他研究结果表明，政策制定者可以通过多种方式针对性地加强过渡项目，在控制成本的同时切实改善人们的生活。
