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Outcomes in a nursing home transition case-management program targeting new admissions
Robert Newcomer1, Taewoon Kang, Carrie Graham
1Department of Social and Behavioral Sciences, University of California, 3333 California Street, Suite 455, San Francisco, CA 94118, USA. robert.newcomer@ucsf.edu
Purpose:
The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a nursing home discharge plan.
Design And Method:
Reported are the results of a randomized control design evaluating the program's effectiveness. Those individuals randomly assigned to the intervention group (n = 33) received PACT case management in addition to their usual medical and nursing home care. The individuals in the control group (n = 29) continued their usual care.
Result:
There were no statistical differences in the discharge rate (84% treatment vs 76% controls) or in the median length of stay (42 days vs 55 days) between the two groups of individuals.
Implications:
Replications or extensions of a PACT-type intervention might consider a broader mix of nursing homes, working directly with the nursing home's admission Minimum Data Set coordinator in patient selection, or working with Medicare or Medicaid HMO plans.
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