title: Can we afford consumers choice in home care?
abstract: As demands for home care escalate in a system concerned with cost containments, initiatives promoting client involvement in the management oftheir chronic illnesses and attendant services have attracted increasing attention. For longer term in-home care, varied approaches to case management reflect these trends. This article reports a study exploring the cost consequences of clients' choice of three approaches to case management within a single home care context. The first involved leaving the control of services and care to the system's case manager. The second option was to share this control in partnership with their in-home service providers. The third approach featured clients directing their own case management Overall the average costs per month of services for clients in the three groups did not differ significantly over 6 or more months. However, clients who chose direct involvement in their case management actually had significantly lower cost increases than clients with little control over their case management. While further investigation is needed, offering clients choice of involvement in their in-home case management may both lower costs and optimize clients' potential for involvement in their care.
authors.affiliation: Faculty of Health Sciences, School of Nursing, University of Western Ontario, London, Canada. cmcwill@uwo.ca
authors.forename: Carol L
authors.initials: CL
authors.lastname: McWilliam
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hoch
authors.forename: Peter C
authors.initials: PC
authors.lastname: Coyte
authors.forename: Peter
authors.initials: P
authors.lastname: Coyte
authors.forename: Moira
authors.initials: M
authors.lastname: Stewart
authors.forename: Evelyn
authors.initials: E
authors.lastname: Vingilis
authors.forename: Catherine
authors.initials: C
authors.lastname: Ward-Griffin
authors.forename: Allan
authors.initials: A
authors.lastname: Donner
authors.forename: Gina
authors.initials: G
authors.lastname: Browne
authors.forename: Karen
authors.initials: K
authors.lastname: Anderson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D019090:Case Management; D002908:Chronic Disease; D003258:Consumer Behavior; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D008297:Male; D010865:Pilot Projects