Participants in the Program of All-Inclusive Care for the Elderly (PACE) demonstration: Developing disease-impairment-disability profiles

The Program of All-inclusive Care for the Elderly (PACE) builds on On Lok's community-based care and financing model for disabled elderly people who a re state certified as eligible for nursing home care. Yet PACE's diverse po pulation has not been fully described. We obtained data for a complete cros s-section of PACE participants from early 1997 (N = 2,917). Using grade-of- membership analysis, we classified participants on the basis of their speci fic diseases, impairments, and disabilities. The classification was reviewe d by a physician panel to produce clinical profiles, which were then valida ted against participants' PACE tenure, demographics, supports, and health. Cognitive impairment, incontinence, and activities of daily living disabili ties were influential in producing eight types, which correspond predictabl y to responses in tenure (the more disabled, ill types likely to be in PACE longer), demographics, health, and informal support.