Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 55, Issue 3, Pages 439-444Publisher
WILEY
DOI: 10.1111/j.1532-5415.2007.01079.x
Keywords
home care; case manager; nursing home admission
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OBJECTIVES: To explore the relationship between a case management approach and the risk of institutionalization in a large European population of frail, old people in home care. DESIGN: Retrospective cohort study. SETTING: Eleven European countries. PARTICIPANTS: Three thousand two hundred ninety-two older adults receiving home care (mean age 82.3 +/- 7.3). MEASUREMENTS: Data on nursing home admission were collected every 6 months for 1 year. RESULTS: One thousand one hundred eighty-four (36%) persons received a home care program based on case management, and 2,108 (64%) received a traditional care approach (no case manager). During the 1-year follow-up, 81 of 1,184 clients (6.8%) in the case management group and 274 of 2,108 (13%) in the traditional care group were admitted to a nursing home (P <.001). After adjusting for potential confounders, the risk of nursing home admission was significantly lower for participants in the case management group than for those in a traditional care model (adjusted odds ratio=0.56, 95% confidence interval=0.43-0.63). CONCLUSION: Home care services based on a case management approach reduce risk of institutionalization and likely lower costs.
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