The Cleveland Alzheimer's managed care demonstration: outcomes after 12 months of implementation.
OBJECTIVE
This demonstration evaluates the effects of integrating Alzheimer's Association care consultation service with health care services offered by a large managed care system. The primary hypothesis is that Association care consultation will decrease service utilization, increase satisfaction with managed care, and decrease caregiver depression and care-related strain. Secondary modifying-effects hypotheses posit that the effects of the intervention will be intensified when patients have not received a firm dementia diagnosis, patients have more severe memory problems, caregivers use other Association services in tandem with care consultation, and caregivers are not patients' spouses.


METHODS
The demonstration is a randomized trial that examines outcomes after a 12-month study period. Interview data from 157 primary family caregivers are combined with data abstracted from medical/administrative records.


RESULTS
Support for the primary hypothesis is found for selected, but not all, service utilization outcomes and for caregiver depression. Support for secondary modifying-effects hypotheses is found for satisfaction outcomes and care-related strain outcomes.


CONCLUSIONS
Care consultation delivered within a partnership between a managed care health system and an Alzheimer's Association is a promising strategy for improving selected outcomes for patients with dementia and their caregivers.
Bass
David M
DM
Benjamin Rose, Cleveland, OH 44114, USA. dbass@ben-rose.org
Clark
Patricia A
PA
Looman
Wendy J
WJ
McCarthy
Catherine A
CA
Eckert
Sharen
S
D000368:Aged; D000544:Alzheimer Disease / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D008499:Medical Records; D008605:Mental Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D009820:Ohio; D011787:Quality of Health Care; D012657:Self-Help Groups; D016896:Treatment Outcome