The triage experiment in coordinated care for the elderly

Area of Science:

• Gerontology
• Health Services Research
• Social Work

Background:

• Organizational and financial barriers hinder appropriate care for the elderly.
• Integrated care models are needed to address complex elder care needs.
• The Triage project aimed to mitigate these barriers.

Purpose of the Study:

• To evaluate the effectiveness of the Triage model in improving care for the elderly.
• To assess functioning status outcomes, service utilization, and healthcare costs.
• To determine the feasibility of financing such a model through Medicare waivers.

Main Methods:

• A quasi-experimental study comparing 307 Triage clients to 195 elderly individuals in a control group.
• Interdisciplinary teams (nurse clinician, social worker) provided assessment, coordination, and monitoring.
• Services were financed via Medicare Trust Fund waivers.

Main Results:

• Triage clients showed slightly improved mental functioning outcomes compared to the control group.
• Physical and social functioning outcomes were inconclusive between the groups.
• Service utilization and overall costs were higher for Triage clients, with utilization increasing more proportionally than costs.

Conclusions:

• The Triage model demonstrated some benefits in mental functioning for elderly care.
• While increasing service use and costs, the model's financing through Medicare waivers warrants further investigation.
• Further research is needed to clarify physical and social functioning impacts and optimize cost-effectiveness.