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Senile dementia: public policy and adequate institutional care
Elaine Brody, M. Powell Lawton, Bernard Liebowitz. American Journal of Public Health, 1984-12-01
Topic: Risk, prevention and care in population studies
Increasing costs of institutional care for the aged have occasioned a variety of government cost containment measures. People with senile dementia of the Alzheimer's type (SDAT) will be the principal group to suffer from cutbacks. SDAT patients are usually eligible for Intermediate Care Facilities (ICFs), rather than Skilled Nursing Facilities (SNFs) and therefore for lower reimbursement. Because such patients require heavy care and are the ones most likely to be Medicaid-dependent, nursing homes are being provided with incentives to prevent admissions. At the same time, community services to aid overburdened caregivers are grossly inadequate. Costs to other parts of the health systems are increased by backups in acute hospitals when nursing home beds cannot be found. SDAT and Medicaid eligibility are the principal causes of such "administratively necessary" backup days, but in the main Diagnostic Related Groups (DRGs) may close even that temporary resource. Thus, virtually all avenues of care are shrinking for those who need them most.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Brody, E., Lawton, M. P., & Liebowitz, B. (1984). Senile dementia: public policy and adequate institutional care. American Journal of Public Health. https://doi.org/10.2105/ajph.74.12.1381
Vancouver
Brody E, Lawton MP, Liebowitz B. Senile dementia: public policy and adequate institutional care. American Journal of Public Health. 1984. doi:10.2105/ajph.74.12.1381. PMID: 6439060.
BibTeX
@article{brody1984-6439060,
author = {Brody, Elaine and Lawton, M. Powell and Liebowitz, Bernard},
title = {{Senile dementia: public policy and adequate institutional care}},
journal = {American Journal of Public Health},
year = {1984},
doi = {10.2105/ajph.74.12.1381},
pmid = {6439060},
url = {https://doi.org/10.2105/ajph.74.12.1381}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Because such patients require heavy care and are the ones most likely to be Medicaid-dependent, nursing homes are being provided with incentives to prevent admissions.
- At the same time, community services to aid overburdened caregivers are grossly inadequate.
- Costs to other parts of the health systems are increased by backups in acute hospitals when nursing home beds cannot be found.
- SDAT and Medicaid eligibility are the principal causes of such "administratively necessary" backup days, but in the main Diagnostic Related Groups (DRGs) may close even that temporary resource.
- Thus, virtually all avenues of care are shrinking for those who need them most.
Why it matters
This policy paper argues that cost containment measures and inadequate community services are shrinking care options for people with senile dementia of the Alzheimer's type. It concerns institutional care policy and funding, not treating, curing, or preventing Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (American Journal of Public Health) |
| Journal's citation record | 3 / 4 | American Journal of Public Health: journal h-index 422 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1984 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 50 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.1 citations a year over 44 year(s) since 1984 |
| Impact for its field and year | 4 / 6 | Cited 16.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Bernard Liebowitz: h-index 7 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Institute of Behavioral Sciences: institution h-index 50 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 6439060) |
| Free to read | 2 / 2 | Free to read |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.2105/ajph.74.12.1381
- PubMed: 6439060
- Original source →
- Free full text: American Journal of Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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