Life after PACE (Program of All‐Inclusive Care for the Elderly): A retrospective/prospective, qualitative analysis of the impact of closing a nurse practitioner centered PACE site. Issue 11 (27th May 2016)

• Record Type: Journal Article
• Authors: Meunier, Miranda J.; Brant, Jeannine M.; Audet, Simmy; Dickerson, Dustin; Gransbery, Karen; Ciemins, Elizabeth L.
• Is Part Of: Journal of the American Association of Nurse Practitioners. Volume 28:Issue 11(2016)
• Page Start: 596
• Page End: 603
• Publication Date: 2016-05-27
• Subjects: Geriatric -- hospital -- home care -- emergency department (ED) -- activities of daily living (ADL) -- healthcare team -- health policy; Nurse practitioners -- Periodicals; Nursing -- Periodicals; 610.730692
• DOI: 10.1002/2327-6924.12379
• Languages: English
• ISSNs: 2327-6886

Abstract

Abstract: Background and purpose: Caring for frail older adults is a significant healthcare concern as the frailest 10% of the population account for over 70% of healthcare expenditures. Research reveals the use of comprehensive models, such as Program of All‐Inclusive Care for the Elderly (PACE), leads to improved functional outcomes for participants and cost savings through decreased utilization. This study examines how closing a PACE program impacts health outcomes of previously enrolled participants. Methods: Data were collected every 6 months for 2 years via phone surveys on 34 former participants enrolled in the program at the time of the closure. The survey included questions regarding satisfaction with care, activities of daily living (ADLs), instrumental ADLs (IADLs), emergency department (ED) visits, hospitalizations, and use of home health services. Deaths and nursing home placements were monitored. Outcomes were compared during and post‐PACE. Conclusions: Higher numbers of ED visits, hospitalizations, and nursing home placements occurred post‐PACE. PACE/post‐PACE differences in ADL and IADL scores were not significant, nor were death rates. Higher satisfaction existed with PACE versus non‐PACE care. Implications for practice: Comprehensive care programs such as PACE are effective in reducing healthcare utilization, thus limiting costs. Further work is required to maintain, develop, and support comprehensive models similar to PACE.