Mental health services of the rural elderly outreach program.

This paper describes an elderly outreach program (EOP) designed to identify and provide mental health services to the rural elderly. The project integrates a variety of health, mental health, and human service agencies in the planning and delivery of services. Five referral sources are identified and described as well as the assessment, treatment, and referral process. Outcomes are discussed in terms of: characteristics of persons served, ability of the project to identify and deliver mental health services, treatment effectiveness, and cost effectiveness of the project. The EOP seems to have prevented an increase in need for mental health care among Iowans that might have occurred in the program's absence.

An appraisal of the cost-effectiveness of alternative day care settings for frail elderly people.

Three alternative day care settings for a defined subgroup of frail elderly people are evaluated using cost-effectiveness analysis. This subgroup of frail elderly people is a significant minority of day-care users who have specific and separately identifiable needs. Their utilization of day care often results in the expensive use of day hospital resources or inappropriate social centre facilities. By using a mixture of published and original data sources this paper argues that specialist day services for frail elderly people can be considered at least as effective as either day hospital or social centre care. However, although it is concluded that the use of a specialist day service is more cost-effective than the day hospital, more analysis of the benefits of care in social centres is required before any judgement can be made about the relative cost-effectiveness between these settings.