University of Iowa, Iowa City, Iowa, USA.
Iowa State University, Ames, Iowa, USA.
J Appl Gerontol. 2020 Jul;39(7):751-759. doi: 10.1177/0733464818821055. Epub 2019 Jan 2.
In this study, the authors evaluate the 2013 consolidation of Iowa's Area Agencies on Aging (AAA) on the delivery of home and community-based services (HCBS) to older adults in the state. A mixed-methods approach combined a quasi-experimental design using longitudinal service delivery data with qualitative analyses of surveys and interviews with AAA staff and clients. Overall, consolidation had no detectable effect on the proportion of older adults served by the AAAs. Subgroup analysis showed that consolidation increased the average proportion of older adults served in nonmetropolitan counties and the proportion served through congregate meals. AAA staff and clients described both positive and negative aspects of consolidation: better collaboration across agencies, improved consistency in services, significant challenges with completing consolidation processes, and serving expanded geographic areas. As the American population ages and budgetary allocations tighten, findings from this evaluation can inform other states considering similar restructuring efforts.
在这项研究中，作者评估了 2013 年爱荷华州地区老龄化机构（AAA）的整合对该州老年人提供家庭和社区为基础的服务（HCBS）的影响。一种混合方法结合了使用纵向服务提供数据的准实验设计，以及对 AAA 工作人员和客户的调查和访谈的定性分析。总体而言，整合对 AAA 服务的老年人比例没有明显影响。亚组分析表明，整合增加了在非都会县服务的老年人的平均比例，以及通过集体用餐服务的老年人的比例。AAA 工作人员和客户描述了整合的积极和消极方面：机构之间更好的协作，服务的一致性提高，完成整合过程的巨大挑战，以及服务范围的扩大。随着美国人口老龄化和预算分配收紧，这项评估的结果可以为其他考虑类似重组工作的州提供信息。
