Long-Term Care Policy Issues: Alternatives to Institutional Care

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Abstract
Americans are living longer today than ever before in history. There will be about 31.8 million elderly people by the year 2000. The basic issue facing government today is how to provide or pay for quality care at an afford able price. It is recognized that institutionalization of the elderly is essential for some but inappropriate for others. Doc umentation is available to show that deterioration of patients' conditions can be linked directly to institutionalization and prolonged bed rest. Of the one million elderly persons in long-term care fa cilities, 17 to 25 percent are placed there because there are no alternative care services available to them. The Depart ment of Health, Education, and Welfare has undertaken a major effort to include home health and social services as part of a broad cost containment effort to prevent inappropri ate institutionalization. Home health and community services need to be linked with the total health care delivery system. There must also be an assessment system to assure that ap propriate and effective services are delivered to the right individuals. The Patient Appraisal, Care-Planning, and Eval uation (PACE) program, developed and tested by the Depart ment, provides such a system. In order to provide effective and quality services for the elderly, a partnership is required that will involve federal, state, and local governments, and providers and consumers of health services.

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