Gonzalez Lori
a Research Faculty, Claude Pepper Center , Florida State University , Tallahassee , Florida , USA.
J Aging Soc Policy. 2017 Oct-Dec;29(5):475-490. doi: 10.1080/08959420.2017.1281092. Epub 2017 Jan 13.
For over four decades, the Program of All-Inclusive Care for the Elderly (PACE) has been operated by nonprofit organizations. Research has demonstrated that nonprofit PACE provides quality, cost-effective community-based care to older adults who would otherwise require a nursing home level of care. Recently, the U.S. Secretary of the Department of Health and Human Services has authorized for-profit entities to operate PACE, contingent on their ability to demonstrate that they can provide care that is similar to nonprofit PACE with regard to access to care, quality of care, and cost-effectiveness. In 2013, a study was conducted to evaluate how PACE operates under for-profit versus nonprofit status. The results were presented to Congress which, in turn, authorized for-profit PACE providers. This article critiques the 2013 study, offers a comparison to for-profit hospice, and argues that at best there is not enough evidence to conclude that for-profit PACE provides the same quality of care as existing nonprofit operators.
四十多年来，老年人全包式护理项目（PACE）一直由非营利组织运营。研究表明，非营利性PACE为那些原本需要养老院护理水平的老年人提供高质量、具有成本效益的社区护理。最近，美国卫生与公众服务部部长已授权营利性实体运营PACE，但前提是它们能够证明自己在获得护理服务、护理质量和成本效益方面能够提供与非营利性PACE类似的护理。2013年，开展了一项研究，以评估PACE在营利性与非营利性状态下的运营情况。研究结果提交给了国会，国会进而授权营利性PACE提供者。本文对2013年的研究进行了批判，与营利性临终关怀进行了比较，并认为，充其量没有足够的证据得出营利性PACE提供与现有非营利性运营者相同质量护理的结论。
