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Related Experiment Videos

Determinants of client termination in hospital-based case management programs

F E Netting, L H Warrick, J B Christianson

    Journal of Case Management
    |January 1, 1994
    PubMed
    Summary

    Hospital-based case management (HBCC) programs help frail elderly individuals. About half of clients exit HBCC within 12 months due to death, relocation, or improved self-sufficiency, with cognitive and functional status predicting outcomes.

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    Area of Science:

    • Gerontology
    • Health Services Research
    • Public Health

    Background:

    • Growing focus on hospital-based programs for frail elderly care.
    • Need to understand client outcomes and program effectiveness in hospital-based case management (HBCC).

    Purpose of the Study:

    • To analyze termination reasons for clients in hospital-based case management (HBCC) programs.
    • To identify factors predicting case management termination in both hospital- and community-originated clients.

    Main Methods:

    • Analysis of baseline, 3-, 6-, and 12-month assessment data from an HBCC demonstration.
    • Examination of subsamples of community- and hospital-originated clients.

    Main Results:

    • Approximately 50% of clients (both hospital- and community-originated) terminated within 12 months.

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  • Common termination reasons included death, nursing home placement, referral, relocation, or self-sufficiency.
  • Hospital-originated clients had a higher mortality rate within the first 6 months.
  • Cognitive and functional abilities significantly predicted termination status.

    • Conclusions:

    • Hospital-based case management (HBCC) demonstrates significant client turnover within the first year.
    • Client characteristics, particularly cognitive and functional status, are key predictors of program completion or termination.
    • Further research is needed to optimize HBCC programs for sustained support of the frail elderly.