APPLYING ORGANIZATIONAL THEORY TO IMPROVE THE CONTINUITY OF HEALTH-SERVICES FOR OLDER PERSONS

Given the multiple health problems faced by many older Americans, and the range of health care settings and professionals who serve their needs, it is not surprising that many experience serious discontinuities in care. This article examines research conducted on previous approaches to addressing discontinuities, such as case management to enable frail elderly to remain in home and community settings. The article identifies limits in such approaches, in particular their focus on solving problems at the individual rather than at the organizational and system levels. It proposes that the application of theories of interorganizational relations, in particular resource dependency and transaction costs theories, may better address the structural factors that determine the persistence of discontinuities in the experiences of the elderly.