Case management and risk of nursing home admission for older adults in home care: results of the AgeD in HOme Care Study.
OBJECTIVE
To explore the relationship between a case management approach and the risk of institutionalization in a large European population of frail, old people in home care.


METHODS
Retrospective cohort study.


METHODS
Eleven European countries.


METHODS
Three thousand two hundred ninety-two older adults receiving home care (mean age 82.3+/-7.3).


METHODS
Data on nursing home admission were collected every 6 months for 1 year.


RESULTS
One thousand one hundred eighty-four (36%) persons received a home care program based on case management, and 2,108 (64%) received a traditional care approach (no case manager). During the 1-year follow-up, 81 of 1,184 clients (6.8%) in the case management group and 274 of 2,108 (13%) in the traditional care group were admitted to a nursing home (P<.001). After adjusting for potential confounders, the risk of nursing home admission was significantly lower for participants in the case management group than for those in a traditional care model (adjusted odds ratio=0.56, 95% confidence interval=0.43-0.63).


CONCLUSIONS
Home care services based on a case management approach reduce risk of institutionalization and likely lower costs.
Onder
Graziano
G
Department of Gerontology, Catholic University Sacred Heart, Rome, Italy. graziano_onder@rm.unicatt.it
Liperoti
Rosa
R
Soldato
Manuel
M
Carpenter
Iain
I
Steel
Knight
K
Bernabei
Roberto
R
Landi
Francesco
F
D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005060:Europe; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D013223:Statistics as Topic