Community-based case management and health care use in older adults: outcomes of a collaborative multiagency approach.
Case management (CM) establishes valuable connections between clients and needed supports. There are, however, mixed results on its prediction of health care use. This quasi-experimental record review (N = 96) of a collaborative CM consortium examined predictors of health care use among older adults (aged older than 60 years) who had received CM for at least 6 months. Descriptive, bivariate, and multivariate models were used to predict differences in outcomes (hospitalization and emergency room [ER] visits) between participants who received CM and those who did not. Hospitalization rates were significantly lower among CM recipients. Living alone, identifying as White/non-Hispanic, and higher numbers of medications were significant copredictors of hospital use. CM was not a significant predictor of ER use. Race/ethnicity, however, remained significant in that White/non-Hispanic participants were 4 times likely to have at least 1 ER visit than persons of color. Implications for future research are discussed to promote better understanding of the effectiveness of CM, particularly within ethnically and racially diverse communities. Further inquiry is needed around the experiences of older adults of color, those who live alone, or who take multiple medications as needed. Further testing of a consortium model is necessary to determine value added through a multiagency approach.
Nancy
N
Giunta
Kathleen
K
Cain
D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management; D019058:Community Networks / Q000458:organization & administration*; D003299:Cooperative Behavior; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008485:Medical Audit; D009518:New York