Change in VA Community Living Centers 2004-2011: Shifting Long-Term Care to the Community

被引：34

作者：

Thomas, Kali S. ^{[1
,2
]}

Cote, Danielle ^{[1
]}

Makineni, Rajesh ^{[1
,2
]}

Intrator, Orna ^{[3
,4
]}

Kinosian, Bruce ^{[5
,6
]}

Phibbs, Ciaran S. ^{[7
,8
,9
,10
]}

Allen, Susan M. ^{[1
,2
]}

机构：

[1] US Dept Vet Affairs, Med Ctr, Ctr Innovat Long Term Serv & Supports, Providence, RI USA

[2] Brown Univ, Sch Publ Hlth, Ctr Gerontol & Hlth Care Res, Providence, RI 02912 USA

[3] US Dept Vet Affairs, Med Ctr, Geriatr & Extended Care Data Anal Ctr, Canandaigua, NY USA

[4] Univ Rhocester, Dept Publ Hlth Sci, Med Ctr, Rochester, NY USA

[5] US Dept Vet Affairs, Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA

[6] Univ Penn, Perelman Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA

[7] VA Palo Alto Hlth Care Syst, Hlth Econ Resource Ctr, Palo Alto, CA USA

[8] VA Palo Alto Hlth Care Syst, Ctr Innovat Implementat, Palo Alto, CA USA

[9] Stanford Univ, Sch Med, Dept Pediat, Palo Alto, CA 94304 USA

[10] Stanford Univ, Sch Med, Ctr Primary Care & Outcomes Res, Palo Alto, CA 94304 USA

来源：

JOURNAL OF AGING & SOCIAL POLICY | 2018年 / 30卷 / 02期

关键词：

Veterans Health Administration; long-term care; Community Living Centers; Veterans; NURSING-HOME RESIDENTS; CULTURE CHANGE; VETERANS; QUALITY; SERVICES; LIFE; END;

D O I：

10.1080/08959420.2017.1414538

中图分类号：

R4 [临床医学]; R592 [老年病学];

学科分类号：

1002 ; 100203 ; 100602 ;

摘要：

The United States Department of Veterans Affairs (VA) is facing pressures to rebalance its long-term care system. Using VA administrative data from 2004-2011, we describe changes in the VA's nursing homes (called Community Living Centers [CLCs]) following enactment of directives intended to shift CLCs' focus from providing long-term custodial care to short-term rehabilitative and post-acute care, with safe and timely discharge to the community. However, a concurrent VA hospice and palliative care expansion resulted in an increase in hospice stays, the most notable change in type of stay during this time period. Nevertheless, outcomes for Veterans with non-hospice short and long stays, such as successful discharge to the community, improved. We discuss the implications of our results for simultaneous implementation of two initiatives in VA CLCs.

引用

页码：93 / 108

页数：16

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