Comparison of the Program of All-Inclusive Care for the Elderly (PACE) participants to nursing home participants at program entry

This study investigated the functional status differences of PACE and nursing home (NH) participants at program entry. Analysis of the research literature revealed that such a comparison had not been systematically investigated. As the elderly population increases in the US, as well as the cost for long term care (LTC) services, evaluation of the LTC programs in terms of care delivery and cost becomes necessary. Operating under capitation, the PACE program was established to provide community dwelling elders with acute and LTC services. In order to assess the success of the PACE model and its ability to provide care compared to NHs, baseline characteristics of people admitted to these programs must be compared to determine whether these two programs serve elderly with similar functional characteristics.; A retrospective cross sectional comparison design was used to test differences among four groups. Data about participants were taken from three sources, the Minimum Data Set (MDS), the 1999 National Nursing Home Survey (NNHS) and data from a PACE site. Three comparisons were made, NH in Pennsylvania (MDS-PA1) to the NNHS group, the MDS-PA1 group to NH in specific Zip codes in Pennsylvania (MDS-PA2) and MDS-PA2 group to the PACE group. The results showed that the MDS-PA1 group was more dependent in ADL than the NNHS group (p < 0.0001) and the MDS-PA2 group (p was <0.05 for all variables). The MDS-PA2 group was found to be significantly more dependent in ADL than the PACE group (p was <0.05 in all variables). The overall results of the study indicated that PACE participants were at a higher functional level than the NH participants in all groups. Thus, the PACE program appears to be correctly identifying those elders who will benefit from their services. The findings of the study also suggest that the Medicaid eligibility criteria for NH care allow for the inclusion of a heterogeneous elderly population that requires different levels of care.