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  1. Randomised trial of impact of model of integrated care and case management for older people living in the community.

    Article - En anglais

    Objective 

    To evaluate the impact of a programme of integrated social and medical care among frail elderly people living in the community.

    Design 

    Randomised study with I year follow up.

    Setting 

    Town in northern Italy (Rovereto).

    Subjects 

    200 older people already receiving conventional community care services.

    Intervention 

    Random allocation to an intervention group receiving integrated social and medical care and case management or to a control group receiving conventional care.

    Main outcome measures 

    Admission to an institution, use and costs of health services, variations in functional status.

    Results 

    Survival analysis showed that admission to hospital or nursing home in the intervention group occurred later and was less common than in controls (hazard ratio 0.69 ; 95% confidence interval 0.53 to 0.91).

    Health services were used to the same extent, but control subjects received more frequent home visits by general practitioners In the intervention group the estimated financial savings were in the order of £ 1125 ($ 1800) per year of follow up.

    The intervention group had improved physical function (activities of daily living score improved by 5.1% v 13.0% loss in controls ; P<0.001).

    Decline of cognitive status (measured by the short portable mental status questionnaire) was also reduced (3.8% v 9.4% ; P<0.05). (...)

    Mots-clés Pascal : Soin intégré, Système santé, Evaluation performance, Hospitalisation, Analyse avantage coût, Performance physique, Cognition, Evolution, Italie, Europe, Vieillard, Homme

    Mots-clés Pascal anglais : Managed care, Health system, Performance evaluation, Hospitalization, Cost benefit analysis, Physical performance, Cognition, Evolution, Italy, Europe, Elderly, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0246963

    Code Inist : 002B30A03B. Création : 11/09/1998.