Dementia care management in an underserved community: The comparative effectiveness of two different approaches

Joshua Chodosh, Benjamin A. Colaiaco, Karen Ilene Connor, Dennis Wesley Cope, Hangsheng Liu, David Avram Ganz, Mark Jason Richman, Debra Lynn Cherry, Joseph Moshe Blank, Raquel Del Pilar Carbone, Sheldon Mark Wolf, Barbara Grace Vickrey

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

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.

Original languageEnglish
Pages (from-to)864-893
Number of pages30
JournalJournal of Aging and Health
Volume27
Issue number5
DOIs
StatePublished - 11 Aug 2015
Externally publishedYes

Keywords

  • Alzheimer's
  • care management
  • comparative effectiveness
  • dementia
  • health care delivery

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