Since its inception in 1965, the Older Americans Act has provided social services free of charge to older people, regardless of income. In recent years, the scarcity of resources has sparked a debate as to whether participants who can afford to pay for services should be required to do so. Of concern is whether charging fees will change the fundamental nature of these popular programs by imparting a "welfare" stigma. Other programs that require fees vary enormously by state, and there has been little documentation of their impact on participation, equity of service delivery, or public attitudes. In order to evaluate current proposals, it is necessary to analyze the distributional effects of the cost-sharing system, how the program will be administered, what impact it will have on service use, which services would be subject to cost sharing and at what income levels, and what constitutes a "reasonable" fee for service.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1300/J031v04n01_06 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
"I Won't Put Myself or My Family Through That": Decision Preferences, Family Experiences, and Kidney Disease Decision-Making.
Gerontologist
January 2025
Center on the Ecology of Early Development (CEED), Boston College, Boston, Massachusetts, USA.
Background And Objectives: Chronic kidney disease (CKD) is a major public health concern that uniquely impacts older Black Americans, a population also likely to have family members also diagnosed with CKD. This study aimed to (1) describe how participants viewed their decision preferences considering the experiences of family, and friends previously diagnosed with CKD, and (2) to understand how these social complexities informed their own decisions for future CKD care.
Research Design And Methods: Utilizing a phenomenologically-informed approach, this study explored participants' perceptions of how patients and their family members' experiences with CKD influenced treatment-related decision-making.
Background: There has been an increase in both primary anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) over the last decade, with rates peaking for patients aged 75 years and older. Despite aTSA being the mainstay of treatment for patients with glenohumeral arthritis in the absence of rotator cuff insufficiency, there has been an upward trend of rTSA utilization in the elderly due to concerns about rotator cuff integrity, regardless of deformity. The purpose of this study is to evaluate outcomes including pain, function, range of motion, satisfaction, and complications in patients 80 years or older following primary anatomic and reverse total shoulder arthroplasty for osteoarthritis without full thickness rotator cuff tears.
View Article and Find Full Text PDFUnique considerations in the assessment and management of traumatic brain injury in older adults.
Lancet Neurol
February 2025
Department of Neurology AB51, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
The age-specific incidence of traumatic brain injury in older adults is rising in high-income countries, mainly due to an increase in the incidence of falls. The severity of traumatic brain injury in older adults can be underestimated because of a delay in the development of mass effect and symptoms of intracranial haemorrhage. Management and rehabilitation in older adults must consider comorbidities and frailty, the treatment of pre-existing disorders, the reduced potential for recovery, the likelihood of cognitive decline, and the avoidance of future falls.
View Article and Find Full Text PDFManagement of renal cell carcinoma with ablation in comparison to nephrectomy: A 5-year analysis of inpatient procedural data to evaluate utilization disparities in the United States.
Clin Imaging
January 2025
Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Purpose: To perform a nationwide analysis of ablation compared to partial and total nephrectomy for the management of renal cell carcinoma (RCC) to evaluate utilization trends and disparities in the USA.
Materials And Methods: The 2016-2020 National Inpatient Sample was analyzed. Using ICD-10, we identified the diagnosis of RCC then analyzed the utilization trends of ablation and nephrectomies (both partial and complete).
Minimal extra-cardiac atherosclerosis present in young people with sudden cardiac death due to coronary artery disease.
Eur J Prev Cardiol
January 2025
St Vincent's Institute of Medical Research, 9 Princes St Fitzroy VIC 3065 Australia.
Aim: To define the association between severe coronary artery disease and widespread atherosclerosis in younger individuals.
Methods: Individuals aged 1-50 years with sudden cardiac death (SCD) from 2019-23, autopsy-proven to be due to coronary artery disease, were identified using the state-wide EndUCD registry. Presence of extra-coronary atherosclerosis greater than modified American Heart Association class III was assessed in 5 arterial beds (intra-cerebral vessels, aorta, carotid, renal and femoral arteries).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!