Although Adult Day Health Care (ADHC) is increasingly prominent in the
continuum of long-term care services, the results from previous studi
es of the effects of ADHC are mixed. The objectives of the ADHC Evalua
tion Study were to determine the effect of ADHC on health status, util
ization, and cost of care. The first phase was a randomized controlled
trial evaluating ADHC provided directly by the VA. Patients at four m
edical centers (n = 826) were randomly assigned to receive either ADHC
or customary care, and outcomes were compared for the two groups. The
second phase was a prospective cohort study evaluating ADHC provided
under contract to community agencies in which patients at four additio
nal medical centers (n = 163) were assigned to contract ADHC programs.
Outcomes were compared with those of similar patients in the randomiz
ed trial. Patients and care givers were assessed at intake and 6 and 1
2 months after intake. To be admitted to the study, patients must have
met one of the following criteria: residence in a nursing home; depen
dence in ambulation, dressing, or toileting; bowel incontinence; or si
gnificant cognitive impairment. Patients at intake demonstrated major
impairment in function and high levels of prior use of health care ser
vices.