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Related Experiment Videos

Case management, client risk factors and service use.

R Newcomer1, P Arnsberger, X Zhang

  • 1Department of Social and Behavioral Sciences, University of California, San Francisco 94143-0642, USA.

Health Care Financing Review
|March 3, 1998
PubMed
Summary

Case management activities, particularly monitoring and clinical nursing, show protective effects against nursing home placement and hospitalization for Alzheimer's patients. Understanding these differences can improve care outcomes.

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Area of Science:

  • Gerontology
  • Health Services Research
  • Nursing

Background:

  • Alzheimer's Disease (AD) presents complex care needs.
  • Effective case management is crucial for AD patient outcomes.
  • Differentiated case management strategies may optimize service delivery.

Purpose of the Study:

  • To identify distinct types of case-manager activities in Alzheimer's care.
  • To examine the relationship between case-manager actions and client/caregiver characteristics.
  • To assess the predictive validity of case-manager activities on service use outcomes.

Main Methods:

  • Analysis of chart data from 922 cases in the Medicare Alzheimer's Disease Demonstration.
  • Identification of six "pure" types of case-manager activity.

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  • Statistical assessment of associations between activities, client/caregiver characteristics, and service use.

    • Main Results:

    • Case-manager activity types were identified and differentiated.
    • Activities were more strongly associated with caregiver characteristics than client characteristics.
    • Monitoring and service management protected against nursing home placement.
    • Clinical nursing emphasis protected against hospitalization.

    Conclusions:

    • Specific case-manager activities have differential impacts on patient outcomes.
    • Tailoring case management approaches based on activity type can be beneficial.
    • Improved understanding of case management differentiation can enhance staffing and protocols for better client outcomes.