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The Long Term Care Crisis
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The Long Term Care Crisis
Elders Trapped in the No-Care Zone

  • Carroll L. Estes - School of Medicine, University of California, San Francisco, University of California, San Francisco, USA
  • James H. Swan - Wichita State University, USA


© 1999 | 351 pages | SAGE Publications, Inc
This book examines the implementation of the prospective payment system (PPS) in the US for Medicare hospital reimbursement, which started in 1983.

The authors discuss the impact of the PPS on health care provision and conclude that rather than improving conditions for the elderly in their transition from hospital to community and decreasing escalating health costs, the PPS has restructured the system with the result that the greater financial burden is placed on informal caregivers, community and home health care agencies and the elderly themselves.

 
Introduction
 
PART ONE: OVERVIEW
 
Prospective Payment Revolution and Long Term Care
 
Restructuring of the Nonprofit Sector
 
PART TWO: FROM HOSPITAL TO COMMUNITY
 
Discharge Planners as Gatekeepers to Community Care
 
Does Out of the Hospital Mean Out of Luck?
 
Service Paradox
 
PART THREE: HOME HEALTH AND NURSING HOME CARE
 
Metamorphosis of Home Health Care
 
Nursing Homes Under Prospective Payment
 
Access to Nursing Home and Home Health Services
 
PART FOUR: ELDER CARE AND THE COMMUNITY
 
Informalization and Community Care
 
Access in Peril
 
Community Variation in Policy Implementation
 
Waves of Change
 
PART FIVE: THE FUTURE
 
Policy Elites and Fiscal Crisis
 
Empowerment Imperative
 
No-Care Zone and Social Policy

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ISBN: 9780803939936
£52.00