OBJECTIVES : Program of All-Inclusive Care for the Elderly (PACE) provides comprehensive medical and social services to community-dwelling older adults. Uncontrolled studies indicate PACE participants have positive outcomes. This scoping review aimed to review published studies that compared PACE outcomes to other similar programs.

METHODS : We used a scoping strategy to search for articles published between January 1, 1997 and March 12, 2021. Studies were included if they: were written in English; set in the United States; evaluated PACE and a comparator program; and reported any economic, clinical, or humanistic outcomes. We searched nine electronic databases. Two reviewers independently screened abstracts and extracted data from relevant articles using standardized forms and resolved discrepancies through consensus.

RESULTS : From 545 articles identified; five studies were included (most did not have a comparator group). Example outcomes included: risk adjusted median PACE survival was 4.2 years, 2.3 years in a nursing home (NH) and 3.5 years in a waiver program for the elderly and disabled in one study (p=0.015). Another study reported 35.0% inpatient admission for enrollees in a Veterans Affairs (VA) model with PACE, 41.0% in VA-community partnership with PACE and 49.0% with VA as sole provider (p>0.05). In a third study, patients in the Wisconsin Partnership Program reported comparable high levels of satisfaction in care with PACE patients. A fourth study reported 33.7% hospital utilization among patients in PACE and 35.2% in a Medicaid-only managed long-term care plan for elders (MMLTC; p=0.0362) and 21.0% in NH utilization in PACE versus 5.7% in MMLTC (p<0.0001). In a fifth study, 22.1% of PACE patients died at 18 months of enrollment versus 10.0% patients in a visiting nurse service (p<0.0001).

CONCLUSIONS : Published comparisons of PACE outcomes versus other programs are rare. The included studies show mixed results. Further studies are needed to compare PACE outcomes to other programs.