title: An Integrated Model of Co-ordinated Community-Based Care.
abstract: OBJECTIVE
  Co-ordinated approaches to community-based care are a central component of current and proposed efforts to help vulnerable older adults obtain needed services and supports and reduce unnecessary use of health care resources.
  
  
  METHODS
  This study examines ElderHelp Concierge Club, an integrated community-based care model that includes comprehensive personal and environmental assessment, multilevel care co-ordination, a mix of professional and volunteer service providers, and a capitated, income-adjusted fee model. Evaluation includes a retrospective study (n = 96) of service use and perceived program impact, and a prospective study (n = 21) of changes in participant physical and social well-being and health services utilization.
  
  
  RESULTS
  Over the period of this study, participants showed greater mobility, greater ability to meet household needs, greater access to health care, reduced social isolation, reduced home hazards, fewer falls, and greater perceived ability to obtain assistance needed to age in place.
  
  
  CONCLUSIONS
  This study provides preliminary evidence that an integrated multilevel care co-ordination approach may be an effective and efficient model for serving vulnerable community-based elders, especially low and moderate-income elders who otherwise could not afford the cost of care. The findings suggest the need for multisite controlled studies to more rigorously evaluate program impacts and the optimal mix of various program components.
authors.affiliation: Social Welfare, School of Social Welfare, University of California, Berkeley. scharlach@berkeley.edu.
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Scharlach
authors.affiliation: Health Research for Action, School of Public Health, University of California, Berkeley.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Graham
authors.affiliation: Social Welfare, School of Social Welfare, University of California, Berkeley.
authors.forename: Clara
authors.initials: C
authors.lastname: Berridge
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012111:Residence Characteristics; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States
keywords: Aging in place; Care co-ordination; Mixed economy of care; Volunteer service provision