The Evaluation of Geriatric Collaborative Practice: Partnering with the Vulnerable Elderly

2.50
Hdl Handle:
http://hdl.handle.net/10755/159402
Type:
Presentation
Title:
The Evaluation of Geriatric Collaborative Practice: Partnering with the Vulnerable Elderly
Abstract:
The Evaluation of Geriatric Collaborative Practice: Partnering with the Vulnerable Elderly
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Schraeder, Cheryl
Contact Address: Health Systems Research Center, PO Box 538, Mahomet, IL, 61853, USA
STUDY AIM: To evaluate the impact of an ambulatory nurse/physician case management model on the delivery, management, and outcomes of health services for selected Medicare (elderly population: age ³ 65) beneficiaries. The study is comparing the effectiveness of the model in an “at-risk” sample of Medicare beneficiaries compared to a traditional utilization control approach to patient care. RESEARCH METHODS AND STUDY DESIGN: A 36 month, longitudinal treatment control group design. The study sample consists of 848 Medicare (elderly population: age ³ 65) beneficiaries (treatment group=487, control group=361) and were determined to be at increased risk for health and functional decline and/or increased health service use by a pre-defined scoring algorithm. The intervention consists of collaborative care teams that combine primary care physicians, nurses, patients and health/community services and includes patient targeting and screening, clinical assessment, monitoring, care planning, arrangement and coordination of needed services, ongoing follow-up, patient education and information reporting to the geriatric primary care teams. Anderson’s Behavioral Model for Vulnerable Populations was used as the framework for evaluating patient specific outcomes, including mortality, health and functional status, preventive health behaviors, health service use and satisfaction with care. CONCLUSIONS: After adjusting for baseline differences, the treatment group had 2.4 fewer total hospital bed days (p<.05) and lower per member per month (PMPM) allowed charges by $215 (p<.05) than the comparison group. Sub-group analyses indicated that the intervention reduced the likelihood of multiple hospitalizations (>2 times during the study period) by 36% (odds ratio=.64, p=.05), reduced total hospital bed days by 3.6 (p=.05), and reduced PMPM total allowed charges by $650 9p=.01). IMPLICATIONS FOR HEALTH POLICY/HEALTH CARE DELIVERY: These preliminary results suggest that an integrated, collaborative approach to primary care can influence service use and cost of care for select Medicare (elderly population: age ³ 65) beneficiaries. AN: MN030346
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Evaluation of Geriatric Collaborative Practice: Partnering with the Vulnerable Elderlyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159402-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Evaluation of Geriatric Collaborative Practice: Partnering with the Vulnerable Elderly</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Schraeder, Cheryl</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value"> Health Systems Research Center, PO Box 538, Mahomet, IL, 61853, USA</td></tr><tr><td colspan="2" class="item-abstract">STUDY AIM: To evaluate the impact of an ambulatory nurse/physician case management model on the delivery, management, and outcomes of health services for selected Medicare (elderly population: age &sup3; 65) beneficiaries. The study is comparing the effectiveness of the model in an &ldquo;at-risk&rdquo; sample of Medicare beneficiaries compared to a traditional utilization control approach to patient care. RESEARCH METHODS AND STUDY DESIGN: A 36 month, longitudinal treatment control group design. The study sample consists of 848 Medicare (elderly population: age &sup3; 65) beneficiaries (treatment group=487, control group=361) and were determined to be at increased risk for health and functional decline and/or increased health service use by a pre-defined scoring algorithm. The intervention consists of collaborative care teams that combine primary care physicians, nurses, patients and health/community services and includes patient targeting and screening, clinical assessment, monitoring, care planning, arrangement and coordination of needed services, ongoing follow-up, patient education and information reporting to the geriatric primary care teams. Anderson&rsquo;s Behavioral Model for Vulnerable Populations was used as the framework for evaluating patient specific outcomes, including mortality, health and functional status, preventive health behaviors, health service use and satisfaction with care. CONCLUSIONS: After adjusting for baseline differences, the treatment group had 2.4 fewer total hospital bed days (p&lt;.05) and lower per member per month (PMPM) allowed charges by $215 (p&lt;.05) than the comparison group. Sub-group analyses indicated that the intervention reduced the likelihood of multiple hospitalizations (&gt;2 times during the study period) by 36% (odds ratio=.64, p=.05), reduced total hospital bed days by 3.6 (p=.05), and reduced PMPM total allowed charges by $650 9p=.01). IMPLICATIONS FOR HEALTH POLICY/HEALTH CARE DELIVERY: These preliminary results suggest that an integrated, collaborative approach to primary care can influence service use and cost of care for select Medicare (elderly population: age &sup3; 65) beneficiaries. AN: MN030346 </td></tr></table>en_GB
dc.date.available2011-10-26T21:58:53Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:58:53Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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