APPLYING ORGANIZATIONAL THEORY TO IMPROVE THE CONTINUITY OF HEALTH-SERVICES FOR OLDER PERSONS

Given the multiple health problems faced by many older Americans, and the range of health care settings and professionals who serve their ne eds, it is not surprising that many experience serious discontinuities in care. This article examines research conducted on previous approac hes to addressing discontinuities, such as case management to enable f rail elderly to remain in home and community settings. The article ide ntifies limits in such approaches, in particular their focus on solvin g problems at the individual rather than at the organizational and sys tem levels. It proposes that the application of theories of interorgan izational relations, in particular resource dependency and transaction costs theories, may better address the structural factors that determ ine the persistence of discontinuities in the experiences of the elder ly.