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Case Management and Risk of Nursing Home Admission for Older Adults in Home Care: Results of the AgeD in HOme Care Study
Author(s) -
Onder Graziano,
Liperoti Rosa,
Soldato Manuel,
Carpenter Iain,
Steel Knight,
Bernabei Roberto,
Landi Francesco
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01079.x
Subject(s) - medicine , institutionalisation , odds ratio , nursing homes , confidence interval , retrospective cohort study , cohort study , cohort , confounding , gerontology , case management , nursing , family medicine , psychiatry , surgery
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.