Abstract:

An examination of issues concerning the use of rationing to control health care expenditures in general, & in the context of care of the aged. Geriatric assessment teams are charged with determining which services best meet their clients' needs, while maximizing effective resource allocation; this creates a potential conflict regarding their primary responsibility-to the individual client, or the budget. Two sets of factors are seen to affect this relationship: (1) the nature of the team's control over & access to resources, & the limits imposed on availability of those resources; & (2) the extent to which the rationing function is made explicit by the team's awareness of the cost implications of its decisions, & its attitudes toward & acceptance of resource limits. These factors are explored via case studies of 4 assessment teams.