Randomized controlled trial of nurse case management of frail older people.
OBJECTIVE
To compare the effects of nurse case management with usual care provided to community-dwelling frail older people in regard to quality of life, satisfaction with care, functional status, admission to hospital, length of hospital stay, and readmission to emergency department.


METHODS
Randomized controlled trial.


METHODS
University hospital and two proximal community health centers.


METHODS
427 frail older people (> or = 70 years of age and at risk for repeated hospital admissions) discharged home from the emergency department.


METHODS



METHODS
Nurse case management, which consisted of coordination and provision of healthcare services by nurses, both in and out of hospital, for a 10-month period.


METHODS
Usual care, which varied by healthcare provider and community health center.


METHODS
Outcomes were assessed 10 months post-randomization by telephone and/or home interview and by medical record review. Questionnaires included the SF-36, CSQ-8, and OARS.


RESULTS
No significant differences were found in quality of life, satisfaction with care, functional status, admission to hospital, or length of hospital stay. Nurse-case-managed older adults were readmitted to the emergency department significantly more often than their usual care counterparts.


CONCLUSIONS
Frail older people receiving nurse case management are more likely to use emergency health services without a concomitant increase in health benefits.
Gagnon
A J
AJ
Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Schein
C
C
McVey
L
L
Bergman
H
H
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management; D002391:Catchment Area, Health; D003152:Community Health Nursing; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D017060:Patient Satisfaction; D011788:Quality of Life; D011792:Quebec