Determinants of client termination in hospital-based case management programs

Increasing attention is being focused on hospital-based programs that address the needs of the frail elderly. This article reports results from a demonstration of hospital-based case management (HBCC). Baseline, 3-, 6-, and 12-month assessment data are analyzed to determine why clients terminated from HBCC programs. Subsamples of community- and hospital-originated clients are examined to determine what factors predict case management termination. About half of both hospital- and community-originated clients left case management within 12 months because of death, nursing home placement, referral to another case management agency, relocation out of the service area, or discharge as self-sufficient. Hospital-originated clients were more likely to die within the first 6 months after entering case management than were community-originated clients. Cognitive and functional abilities were important predictors of termination status.