OBJECTIVES: To determine the effect of a primary care-based care management initiative on residential care placement and death in a population of frail older adults referred for needs assessment in New Zealand. DESIGN: Randomized controlled trial with follow-up at 3, 6, 12, 18, and 24 months for residential care placement and mortality. SETTING: Fifty-five family physician practices in New Zealand that established a care management initiative for older adults assessed as being at high risk of residential care placement in 2004 to 2006. PARTICIPANTS: Three hundred fifty-one individuals (243 female, 108 male) aged 65 and older (mean 81) who were assessed as being at risk of permanent residential care placement. INTERVENTIONS: The care management program (Coordinator of Services for Elderly) consisted of a nominated health professional care manager geographically aligned to family physicians housed with the family physician or located nearby. MEASUREMENTS: Rates of permanent residential care placement and mortality. RESULTS: The risk of permanent residential care placement or death was 0.36 for usual care (control group) and 0.26 for the care management initiative, a 10.2% absolute risk reduction, with the majority of the risk reduction seen in residential care placement (control group 0.25, intervention group 0.16). CONCLUSION: A family physician-aligned community care management approach reduces frail older adults' risk of mortality and permanent residential care placement.
AD - Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. m.parsons@auckland.ac.nz AN - 22239292 BT - Journal of the American Geriatrics Society ET - 2012/01/14 LA - eng M1 - 1 N1 - Parsons, MatthewSenior, HughKerse, NgaireChen, Mei-HuaJacobs, StephenVanderhoorn, StephenAnderson, CraigComparative StudyRandomized Controlled TrialUnited StatesJournal of the American Geriatrics SocietyJ Am Geriatr Soc. 2012 Jan;60(1):86-92. doi: 10.1111/j.1532-5415.2011.03763.x. N2 -OBJECTIVES: To determine the effect of a primary care-based care management initiative on residential care placement and death in a population of frail older adults referred for needs assessment in New Zealand. DESIGN: Randomized controlled trial with follow-up at 3, 6, 12, 18, and 24 months for residential care placement and mortality. SETTING: Fifty-five family physician practices in New Zealand that established a care management initiative for older adults assessed as being at high risk of residential care placement in 2004 to 2006. PARTICIPANTS: Three hundred fifty-one individuals (243 female, 108 male) aged 65 and older (mean 81) who were assessed as being at risk of permanent residential care placement. INTERVENTIONS: The care management program (Coordinator of Services for Elderly) consisted of a nominated health professional care manager geographically aligned to family physicians housed with the family physician or located nearby. MEASUREMENTS: Rates of permanent residential care placement and mortality. RESULTS: The risk of permanent residential care placement or death was 0.36 for usual care (control group) and 0.26 for the care management initiative, a 10.2% absolute risk reduction, with the majority of the risk reduction seen in residential care placement (control group 0.25, intervention group 0.16). CONCLUSION: A family physician-aligned community care management approach reduces frail older adults' risk of mortality and permanent residential care placement.
PY - 2012 SN - 1532-5415 (Electronic)0002-8614 (Linking) SP - 86 EP - 92 T2 - Journal of the American Geriatrics Society TI - Should care managers for older adults be located in primary care? A randomized controlled trial VL - 60 ER -