Dementia Care Management in an Underserved Community: The Comparative Effectiveness of Two Different Approaches. (August 2015)

• Record Type: Journal Article
• Authors: Chodosh, Joshua; Colaiaco, Benjamin A.; Connor, Karen Ilene; Cope, Dennis Wesley; Liu, Hangsheng; Ganz, David Avram; Richman, Mark Jason; Cherry, Debra Lynn; Blank, Joseph Moshe; Carbone, Raquel del Pilar; Wolf, Sheldon Mark; Vickrey, Barbara Grace
• Is Part Of: Journal of aging and health. Volume 27:Number 5(2015:Aug.)
• Page Start: 864
• Page End: 893
• Publication Date: 2015-08
• Subjects: dementia -- Alzheimer's -- care management -- comparative effectiveness -- health care delivery; Older people -- Health and hygiene -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1177/0898264315569454
• Languages: English
• ISSNs: 0898-2643

Abstract

Objectives: To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia.Methods: We randomized 151 patient–caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient–caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up.Results: Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver.Discussion: Dementia care quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected.