Final Report on Qualitative Analysis of the Program of All-Inclusive Care for the Elderly (PACE).

摘要

The purpose of the 18 month study was to qualitatively evaluate the Program of All-inclusive Care for the Elderly (PACE) demonstration during PACE sites' predevelopment and early implementation stages. The PACE demonstration seeks to replicate a model of capitated, comprehensive, risk-based acute and long term care for the frail elderly developed by On Lok Senior Health Services in San Francisco. Hard data, anecdotal evidence and direct observation, obtained during site visits to the original eight PACE sites and On Lok Senior Health Services, and ongoing telephone contact, were used to examine several issues related to the replication. After comparing the PACE sites to On Lok on key characteristics of the PACE model of care, the researchers offer some lessons learned from these sites regarding replicability; sources of start-up and development funds, census building, staffing, and enrollee patient mix are seen as critical issues to future sites. Also offered are some issues to be faced in the impact evaluation, including the difficulty of selecting appropriate comparison groups, data equivalence across experimental and comparison groups, the need to collect additional data regarding patient outcomes (enrollee and family satisfaction, affect, quality of life), and statistical power and the role of pooling data across sites.