Integration of services for elderly people reduced costs and use of health services
Question Does the integration of medical and social services with case management programmes reduce functional decline, admissions to institutions, and the use and costs of health services in frail, elderly people living in the community?
Design
Randomised controlled trial with 12 months follow up.
Setting
A town (Rovereto) in northern Italy.
Patients
200 adults (mean age 81 y, 71% women) who were ≥65 years of age and received home health services or home assistance programmes.
Intervention
Patients in the intervention group (n=100) received case management and care planning by the community geriatric evaluation unit (which included a geriatrician, a social worker, and several nurses), case managers, and general practitioners (GPs). Case managers did the initial assessment, reported it to the geriatric evaluation unit which determined the services that patients were eligible for, and designed and implemented individualised care plans in consultation with GPs. Case managers did assessments every 2 months and were constantly available to deal …
