Composition of the home care service package: predictors of type, volume, and mix of services provided to poor and frail older people.

This study of 270 poor and frail elders in a Medicaid waiver program examined the service package, that is, the type of service (health or social), volume, and the mix or combinations of services provided. Predictors of use and volume of service differed depending on type of service. The most frequently prescribed service combinations were: (a) nursing, home health, and homemaker; (b) homemaker only; (c) nursing and home health; (d) nursing and homemaker; and (e) nurse only. Across the service combinations, living alone increased the odds of receiving social services such as a homemaker, whereas declining primary ADL function increased the odds of receiving health services such as a home health aide.