• Am J Manag Care · Nov 2020

    Effect of care coordination on patients with Alzheimer disease and their caregivers.

    • Brian Chen, Xi Cheng, Blaiz Streetman-Loy, Matthew F Hudson, Dakshu Jindal, and Nicole Hair.
    • Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene St, Ste 354, Columbia, SC 29208. Email: bchen@mailbox.sc.edu.
    • Am J Manag Care. 2020 Nov 1; 26 (11): e369-e375.

    ObjectivesTo assess whether a care coordination and caregiver support intervention reduced use of acute medical services for both patients with Alzheimer disease (AD) and their caregivers.Study DesignData were collected from patients with AD (n = 101) and their caregivers (n = 63) at Greenville Health System (now Prisma Health) in late 2012. Their data were linked to secondary all-payer claims data in South Carolina between 2011 and 2014.MethodsWe conducted both a difference-in-differences regression and segmented regression analysis on the patients' health care utilization patterns pre- and post intervention. Propensity score matching identified a control group composed of nonintervention patients with AD in South Carolina (n = 928). We examined caregiver differences via t tests of differences in means.ResultsOverall, the Memory Program did not reduce acute medical services. However, program participants experienced increases in total charges ($5243; 95% CI, $977-$9510) and in inpatient admissions with AD as a diagnosis (0.15; 95% CI, 0.029-0.272) but no increase in total all-cause charges. Intervention patients also had fewer emergency department (ED) visits (-0.0538; 95% CI, -0.102 to -0.0052) in some analyses. Finally, results suggest that post intervention, caregivers had half as many acute visits with depression as a diagnosis (from 0.22 to 0.11, difference of 0.11; 95% CI, -0.242 to 0.0198).ConclusionsAlthough care coordination did not decrease overall acute health services use, coordination improved clinical documentation of patients' memory impairment. ED visits may have begun to decrease among patients. Finally, stress levels may have fallen among caregivers.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…