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Related Experiment Videos

Care management in three practices--scope for improvement?

B A Hamilton1, W R Primrose, K T Muir

  • 1Department of Medicine for the Elderly, Woodend Hospital, Aberdeen.

Health Bulletin
|June 20, 2003
PubMed
Summary

Hospital and community assessments for older adults needing care homes had similar outcomes, but community assessments lacked medical details and multi-disciplinary input. Enhancing community assessments could improve care and support for frail elderly individuals.

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Area of Science:

  • Gerontology
  • Healthcare Management
  • Social Work

Background:

  • Older adults requiring residential or nursing home care undergo assessments by hospital-based social workers or community-based care managers.
  • Comparing assessment processes in these two settings is crucial for ensuring appropriate care planning.

Purpose of the Study:

  • To compare the assessment processes for older adults requiring residential/nursing home care conducted by hospital social workers versus community care managers.
  • To evaluate the equivalence of data collection, multidisciplinary nature, and appropriateness of outcomes in both assessment settings.

Main Methods:

  • A review of social work case files and care plans for 33 older adults referred for residential/nursing home care (17 community, 16 hospital) between July and December 1997.

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  • Dependency scores were obtained using the Abbreviated Mental Test, Barthel Index, and Clifton Assessment Procedures for the Elderly (CAPE) Behaviour Rating Scale component.
  • Interviews were conducted with individuals in their respective settings (home, hospital, residential/nursing home).

    • Main Results:

    • Case files were well-maintained in both groups, with similar overall outcomes and no statistically significant difference in mean dependency scores.
    • Community-referred individuals had limited information on support levels and a notable absence (47%) of recorded medical assessments.
    • While dependency scores correlated with the appropriateness of care home placement, only 50% of individuals expressed a desire for such arrangements.

    Conclusions:

    • Multidisciplinary assessment was not consistently documented, particularly for community-referred individuals.
    • Increased emphasis on multidisciplinary assessments could identify rehabilitation needs, potentially enabling frail older adults to remain in the community, aligning with their preferences.