Effects of VA adult day health care on health outcomes and satisfaction with care.

Abstract

It was hypothesized that ADHC would have a positive effect on the health of patients and their care givers and result in greater satisfaction with care than customary care. Measurement of health outcomes for patients included assessment of overall, psychological, and social health, and survival. Care giver assessment concentrated on psychosocial health. Findings indicated no difference in health outcomes between patients assigned to ADHC or their care givers and their counterparts assigned to customary care. Further analysis of subgroups found that there were 3 subgroups of patients for whom those assigned to ADHC had better outcomes (as indicated by lower Sickness Impact Profile scores) than those assigned to customary care. These subgroups included those who were 1) not married, 2) most satisfied with their social support network, and 3) not hospitalized at the time of enrollment in the study. Patients and their care givers assigned to ADHC were more satisfied with their care than those in nursing homes, but not more satisfied than those in hospital-based home care. Care givers reported significantly greater satisfaction with patient care in ADHC than did care givers of patients receiving care in nursing homes or ambulatory care clinics.