[Evaluation of gerontologic case management: a socioeconomic approach].
BACKGROUND
The case management approach is increasing in the elderly population. The organizations which support case management agencies now require an economic assessment. This paper presents a methodology and its test at four experimental sites, in order to measure the costs and the effectiveness of the case management and the willingness to pay of potential users of this procedure.


METHODS
Costs were measured from the data collected in 4 agencies. Effectiveness was assessed on the basis of a statistical analysis of 247 care plans, and a survey among health care and social professionals, elderly people and their relatives. A mail survey was used to get data on the willingness to pay.


RESULTS
The average cost of the case management was 24.50 F. Effectiveness included several dimensions: management of the available resources according to the patient's incapacity situation, effective implementation of the care plan, and collective learning leading to reduce inter-professional disagreements. Analysis of the willingness to pay indicated that Social Security and local authorities intended to be the main co-payers of case management.


CONCLUSIONS
The standard framework of economic analysis is not appropriate for an assessment of case management. New instruments are proposed and results have to be validated by further research.
Frossard
M
M
Centre Pluridisciplinaire de Gérontologie, Université Pierre Mendès-France de Grenoble.
Boitard
A
A
D000368:Aged; D019090:Case Management / Q000191:economics / Q000592:standards; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005069:Evaluation Studies as Topic; D006282:Health Personnel; D006801:Humans; D012943:Social Security