title: Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.
abstract: To investigate effects of a novel dementia care coordination program on health services utilization.
  
  
  
  A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011).
  
  
  
  Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team.
  
  
  
  Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months.
  
  
  
  From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005).
  
  
  
  While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Halima
authors.initials: H
authors.lastname: Amjad
authors.affiliation: Rowan University School of Osteopathic Medicine, Stratford, NJ.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Wong
authors.affiliation: Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD.|Center on Aging and Health, Johns Hopkins University, Baltimore, MD.
authors.forename: David L
authors.initials: DL
authors.lastname: Roth
authors.affiliation: Center on Aging and Health, Johns Hopkins University, Baltimore, MD.
authors.forename: Jin
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University School of Public Health, Baltimore, MD.
authors.forename: Amber
authors.initials: A
authors.lastname: Willink
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Betty S
authors.initials: BS
authors.lastname: Black
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Johnston
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.|Department of Community Public Health Nursing, School of Nursing, The Johns Hopkins University, Baltimore, MD.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Constantine G
authors.initials: CG
authors.lastname: Lyketsos
authors.affiliation: Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Quincy M
authors.initials: QM
authors.lastname: Samus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care / Q000458:organization & administration / Q000706:statistics & numerical data; D003704:Dementia / Q000453:epidemiology*; D000078336:Facilities and Services Utilization / Q000706:statistics & numerical data*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008396:Maryland; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team; D016037:Single-Blind Method
keywords: Dementia; care coordination