By the time of its completion, the National Long Term Care Demonstration
project (the "channeling demonstration") was the 27th experiment
or quasi experiment undertaken on the costs and effects of home
and community care. A recent review of findings from all 27 studies
shows that they came to remarkably similar conclusions: home care is
not a cost-saving substitute for nursing home care because few patients
are at risk of institutionalization; reductions in institutionalization are
small; home care costs exceed the small reductions in institutional
costs; and patient outcome benefits are extremely limited, and sometimes
even negative (Weissert, Cready, and Pawelak, in press)
