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Research Studies

The largest study of adult day programs conducted to-date was sponsored by the Robert Wood Johnson Foundation. The National Study of Adult Day Services, conducted by Partners in Caregiving: The Adult Day Services Program (with PMD Advisory Services, LLC and the Seniors Research Group of Market Strategies, Inc.), revolved around three major activities: (1) conducting a census of adult day service providers to determine how many adult day centers exist and where they are located; (2) surveying these providers to determine populations served and services offered; and, (3) identifying gaps in the current service delivery system.

Among other things, this study found that the majority of adult day centers are not-for-profit (78 percent), operate under the umbrella of a large parent organization (70 percent), and are open Monday through Friday, eight or more hours a day. On average, adult day centers serve 25 people per day (with an overall enrollment of 42) at an average cost of $56/day. The average daily fee, however, is $46/day (less than cost). Annual revenue (on average) is $365,208, of which 38 percent comes from third-party public reimbursements (mainly Medicaid Home- and Community-Based Waiver dollars), 35 percent from private pay/out-of-pocket payments, 14 percent from non-operating revenue (such as grants and donations), and 13 percent from other operating revenue (such as private insurance and ancillary services like transportation).

Growth in the adult day services industry is evident, with 26 percent of all adult day centers opening in the last five years. However, growth lags behind the need for the service, with 56 percent of the counties in the United States under served (1,770 counties out of a total of 3,141). The study concludes that the current population base of the United States can support a total of 8,520 adult day centers. With current need not being met, 5,415 new adult day centers are needed nationwide (1,424 in rural areas and 3,991 in urban areas).

To see the Executive Summary or Key Findings of this important study, go to www.rwjf.org/news/special/adultdayServicesSummary.jhtml.

Hard numbers on the effectiveness of adult day programs are hard to come by, as there is not yet any national standard for outcome measures, and data collection at program sites varies in widely in terms of what is collected, who reports it (program or caregiver) and the reliability of information provided. Work is underway to address this issue on a variety of fronts. The Levels of Care Project, funded by the California Healthcare Foundation and commissioned by the The California Association of Adult Day Programs (1999 - 2001) was one such effort. The Adult Day Services Network of Alameda County worked with RTZ Associates on this project. The final report is available in pdf format: www.caads.org/members/pdf/loc_pilot_101801.pdf

On a smaller scale, a study of a single Adult Day Health Care center in Menlo Park in 1998 found very encouraging results: after only 6 months attendance, program participants' emergency room activity decreased by 56%, total hospitalizations decreased by 75%, falls decreased by 72%, and mental status was improved or maintained in 69%.

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