Should care managers for older adults be located in primary care? A randomized controlled trial.
J Am Geriatr Soc
; 60(1): 86-92, 2012 Jan.
Article
em En
| MEDLINE
| ID: mdl-22239292
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
Base de dados:
MEDLINE
Assunto principal:
Médicos de Família
/
Atenção Primária à Saúde
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Administração dos Cuidados ao Paciente
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Idoso Fragilizado
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Gerenciamento Clínico
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Avaliação das Necessidades
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Serviços de Saúde para Idosos
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Revista:
J Am Geriatr Soc
Ano de publicação:
2012
Tipo de documento:
Article