The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #58051

Susanne D. Dragun, MA, Policy Sciences, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250, 410-647-9769, sdragu1@umbc.edu and Nancy A. Miller, PhD, Policy Sciences Graduate Program, UMBC, 1000 Hilltop Circle, Baltimore, MD 21250.

This secondary analysis examines the impact of consumer-directed empowerment interventions on health and quality of life for stroke survivors and their caregivers after one year. The data source is the Randomized Controlled Trial of Primary and Consumer Directed Care for People with Chronic Illnesses Demonstration. The interventions include: 1) a monthly Voucher for medical goods and support services; 2) a Health Promotion Nurse (HPN) as patient health care advocate and primary practice extension; and 3) a Combination (Voucher and HPN). Over 730,000 strokes occur in the US every year, disproportionately affecting people age 65 and older. Stroke is the third leading cause of death and the leading cause of adult disability. Since most disabled stroke survivors are cared for at home, the burden consequently falls on the patient and family member who is typically the caregiver. As a result, health and quality of life is often affected. Inadequate help and lack of Medicare coverage for long-term care compounds this problem. Comparison of baseline and year one data allow an examination of the impact of the interventions on health status and quality of life for stroke survivors and their caregivers. Results show that compared to the Control group, stroke survivors in the HPN group were less likely to die and had better social functioning. The Voucher group rated health compared to others better but had greater role limitation. Additionally, a consistent positive effect was evident for stroke survivors at the NY site. Policy implications for the Medicare program will be discussed.

Learning Objectives:

At the conclusion of this session, the participant will have a better understanding of:
• The impact of consumer-directed empowerment interventions after the fist year on health and quality of life for stroke survivors and their caregivers.
• Policy implications for the Medicare program.

Keywords: 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.