Assessment of Functional Status in a Program Evaluation and Resource Allocation Model

Abstract

Concern about the efficiency and effectiveness of increasingly costly health and welfare services for older persons stimulates interest in systematic evaluation of alterna tive programs. While a single, optimal system for program evaluation and resource allocation does not exist, a strategy developed at Duke University is promising. This strategy, which meets the conditions of a quasi-experiment, has three elements: (1) a reliable, valid procedure for assessing five dimensions of individual functioning; (2) a procedure for disaggregating complex service programs into standard generic units; and (3) a matrix which relates changes in func tioning over time to exposure to identified aggregates of generic services. Partial and complete applications of the strategy in two communities are illustrated.