Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109166

Gerald Eggert, PhD, Executive Director, Monroe County Long Term Care Program, Inc, P.O. Box 429, East Rochester, NY 14445, 585-242-9325, gmeggert@aol.com, Brenda R. Wamsley, PhD, Department of Social Work, West Virginia State University, 928 Wallace Hall, P.O. Box 1000, Institute, WV 25112, Bruce Friedman, PhD, Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue, Box 644, Rochester, NY 14642, Hongdao Meng, PhD, Department of Preventive Medicine, Stony Brook University, HSC, Level 3, Rm071, Stony Brook University, Stony Brook, NY 11794-8338, and Joan Van Nostrand, DPA, Director of Research, Office of Rural Health Policy, HRSA, 5600 Fishers Lane, Rm 9A-55, Rockville, MD 20857.

Eggert presents background about this CD demonstration with a functionally impaired Medicare population (N=1,604). Earlier results indicated that Medicare beneficiaries in a rural sample (N=451) who received a CD Medicare waiver benefit had significantly better ADL outcomes than randomly assigned controls. This Symposium examines cost neutral results from the cost and service analysis. The results have implications for designing cost neutral consumer-directed approaches for Medicare beneficiaries, both rural and urban.

Wamsley presents findings of satisfaction of rural participants (non-MSA) with the consumer-directed benefit compared to their urban (MSA) counterparts.

Meng examined the effect of the health promotion nurse intervention on functional status and health care expenditures among rural participants with hypertension.

Friedman examined differences in health care expenditures of service and control groups among cognitively intact and cognitively impaired participants adjusting for patient sociodemographic and health status variables and for each person's length of time in the study. Among cognitively impaired patients mean total healthcare expenditures were significantly lower for all 3 service groups than for the control group.

Friedman examined differences in health care expenditures of service and control groups for those with depression versus those with no depression adjusting for each person's length of time in the study and for sociodemographic and health status variables.

Corona examined ambulatory care sensitive hospital admissions of the 4 service and control groups for rural and urban participants adjusting for patient sociodemographic variables and for case mix.

Dr. Van Nostrand discusses the cost and service use implications of the CD models.

Learning Objectives:

• This is a symposium. See abstracts for individual papers for learning objectives.

Keywords: Consumer Direction, Rural Populations

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.