The 130th Annual Meeting of APHA

Abstract #35862

Jurgis Karuza, PhD, Finger Lakes Geriatric Education Center, University of Rochester, Monroe Community Hospital, 435 East Henrietta Road, Rochester, NY 14620, 585-760-6366, jkaruza@frontiernet.net, Brenda Wamsley, MSW, Executive Director, Center for Aging & Healthcare in West Virginia, 517 Market Street, Dils Building, Parkersburg, WV 26101, Gerald M. Eggert, PhD, Executive Director, Monroe County Long Term Care Program, Inc./ACCESS, 349 West Commercial Street, Suite 2250, East Rochester, NY 14445, and Bruce Friedman, PhD, Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue, Box 644, Rochester, NY 14642.

Consumer-directed approaches offer strategies that maximize consumer preferences. Few studies exist, however, of the cost and effectiveness of these approaches with a frail Medicare population. This paper describes a randomized controlled trial of primary and consumer-directed care being conducted in parts of West Virginia, Ohio, and New York with an impaired group of 1,609 Medicare beneficiaries and their caregivers. The theoretical framework for the study is reviewed. Two consumer-directed approaches are described: 1) a self-care, health promotion nurse intervention, and 2) a voucher for in-home services and equipment. This study has been completed. Twenty-four months of service use and cost will be presented for three treatment groups (Voucher (V), Health Promotion Nurse (HPN), and Combination (V + HPN)), categorized by rural versus urban (MSA versus non-MSA) residence. This research will help policy makers and practitioners decide if Medicare consumer-directed approaches are effective in rural areas.

Learning Objectives:

• At the conclusion of the presentation, the participant should be able to demonstrate knowledge of three strategies to empower consumers to take more responsibility for their own health care. The participant should also be able to identify some of the cost and service use issues involved in conducting research with a frail, community-based Medicare population in rural areas.

Keywords: Frail Elderly, Consumer Direction

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.