OVERVIEW AND PATIENT RECRUITMENT IN THE ADULT DAY HEALTH-CARE EVALUATION STUDY

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.