The only real flaw in Health Care of the Elderly: An Information Sourcebook is the title. A sourcebook suggests a location to retrieve data; perhaps demographies, utilization data, etc. Rather than providing the source of data, this book provides a systematic analysis and critique of current research on critical long-term care and health care issues affecting the elderly. The book uses the 'Information Synthesis Approach to Reviewing Literature' (Goldschmidt, 1986), which is a rigorous procedure that has decision makers (policymakers, administrators, practitioners) as its primary audience. The process includes a focus on decision-relevant questions, an extensive search strategy to identify appropriate literature, use of explicit criteria to assess the relevance of each potential source, and an examination of the validity of data included in each study. After this thorough review of relevant research findings, the results are examined in terms of implications for future policy and suggestions for additional research. As a result of this methodology, Health Care of the Elderly offers a well-documented synthesis of the numerous volumes of research on tropics such as community care demonstrations, case-mix reimbursement, and case management. Each chapter offers lists of retrieval sources, relevance criteria, search yield, and detailed references as well as tables summarizing methodologies and findings of the cited studies.
Topics for examination were selected as part of a U.S. Veterans Administration (VA) project designed to develop a health services research agenda (Austin, Derham, Hedrick, Perlman and White, 1984). Using a two-step modified Delphi technique, practitioners and researchers identified and prioritized research questions which formed the scope for the book. While the agenda originated in the VA, authors reviewed materials and considered policy and research recommendations beyond the VA health care system. The three resulting substantive divisions of examination include: 1) the elements, organization, and delivery of services in the long-term care system; 2) social support programs for the elderly; and, 3) clinical care issues and physician education.
Within the Elements, Organization, and Delivery of Services in the Long-Term Care System, the first chapter is 'Home and Community Care: Three Decades of Findings' (Weissert, Cready and Pawelak). The next issue addressed examines 'Predictors and Patterns of Nursing Home and Home Care Use' (Shapiro and Roos). Twenty-nine articles were included in the review, however in this case, most were descriptive. This chapter also explores the impact of nursing home residency on hospital use and cohort effects on the use of nursing home and home care services. While the number of sources was much smaller, there was surprising consistency found among the studies as well as stability of the findings over time. Of great concern are variables that distinguish short-stay from long-stay users of nursing home services. While these findings will be useful for targeting and reimbursement of services, it is clear that more research is needed in this area. Austin and O'Connor, in 'Case Management: Components and Program Contexts,' examine 3 1 references based on 16 long-term care demonstration projects. Components 0 1991 by John Wiley & Sons, Ltd.