[Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study].

Autor: van Mierlo LD; Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland., MacNeil-Vroomen J; Afdeling Interne geneeskunde, Sectie Geriatrie, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland., Meiland FJ; Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland., Joling KJ; Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland., Bosmans JE; Afdeling Gezondheidswetenschappen en het EMGO Instituut voor onderzoek naar gezondheid en zorg, Faculteit der Aard- en Levenswetenschappen, Vrije Universiteit Amsterdam, Amsterdam, Nederland., Dröes RM; Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland.; Afdeling Psychiatrie, VUmc, Amsterdam, Nederland., Moll van Charante EP; Afdeling Huisartsgeneeskunde, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland., de Rooij SE; Afdeling Interne geneeskunde, Sectie Geriatrie, Academisch Medisch Centrum, Universiteit van Amsterdam, Amsterdam, Nederland., van Hout HP; Afdeling Huisartsgeneeskunde en Ouderengeneeskunde, EMGO+, VUmc, Amsterdam, Nederland. hpj.vanhout@vumc.nl.; Afdeling Gezondheidswetenschappen, EMGO+, VUmc, Van der Boechorststraat 7, kamer: D558 1081 BT, Amsterdam, Nederland. hpj.vanhout@vumc.nl.
Jazyk: Dutch; Flemish
Zdroj: Tijdschrift voor gerontologie en geriatrie [Tijdschr Gerontol Geriatr] 2016 Dec; Vol. 47 (6), pp. 223-233.
DOI: 10.1007/s12439-016-0197-x
Abstrakt: Background: Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form.
Aim of Study: Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation.
Methods: A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs).
Results: Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group.
Conclusion: The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.
Databáze: MEDLINE
Externí odkaz: