title: [Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study].
abstract: BACKGROUND
  Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form.
  
  
  OBJECTIVE
  Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation.
  
  
  METHODS
  A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs).
  
  
  RESULTS
  Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group.
  
  
  CONCLUSIONS
  The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.
authors.affiliation: Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: van Mierlo
authors.affiliation: Afdeling Interne geneeskunde, Sectie Geriatrie, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland.
authors.forename: Janet
authors.initials: J
authors.lastname: MacNeil-Vroomen
authors.affiliation: Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland.
authors.forename: Franka J M
authors.initials: FJ
authors.lastname: Meiland
authors.affiliation: Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland.
authors.forename: Karlijn J
authors.initials: KJ
authors.lastname: Joling
authors.affiliation: Afdeling Gezondheidswetenschappen en het EMGO Instituut voor onderzoek naar gezondheid en zorg, Faculteit der Aard- en Levenswetenschappen, Vrije Universiteit Amsterdam, Amsterdam, Nederland.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.affiliation: Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland.|Afdeling Psychiatrie, VUmc, Amsterdam, Nederland.
authors.forename: Rose Marie
authors.initials: RM
authors.lastname: Dröes
authors.affiliation: Afdeling Huisartsgeneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Moll van Charante
authors.affiliation: Afdeling Interne geneeskunde, Sectie Geriatrie, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland.
authors.forename: Sophia E J A
authors.initials: SE
authors.lastname: de Rooij
authors.affiliation: Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland. hpj.vanhout@vumc.nl.|Afdeling Gezondheidswetenschappen, EMGO+, VUmc, Van der Boechorststraat 7, kamer: D558 1081 BT, Amsterdam, Nederland. hpj.vanhout@vumc.nl.
authors.forename: Hein P J
authors.initials: HP
authors.lastname: van Hout
mesh_terms: D000368:Aged; D017028:Caregivers; D019090:Case Management / Q000191:economics*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D009426:Netherlands; D011787:Quality of Health Care; D011788:Quality of Life
keywords: Caregiver-implementation; Case management; Cost-effectiveness; Dementia