The cleveland alzheimer's managed care demonstration: Outcomes after 12 months of implementation

Citation Bass, D., Clark, P., Looman, W., McCarthy, C. & Eckert, S. (2003). The cleveland alzheimer's managed care demonstration: Outcomes after 12 months of implementation. The Gerontologist, 43(1), 73-85.

Design Randomized trial

Participants The participants of this study were N=157 family caregivers of a person with Alzheimer's disease.

Outcome / Dependent Variables The dependent variables were: utilization outcomes (# of hospital admissions, # of emergency dept visits, # of physician visits and use of community resources), caregiver satisfaction with health plan, caregiver depression and strain (measured on the CES-D).

Procedure The intervention involved the following levels: care consultation was provided from the Alzheimer's Association with referrals to usual managed care health services offered to Kaiser members, care consultants initiated first contact and conducted follow-ups bi-weekly decreasing to 1-month and 3-month periods, care consultants offered initial assessment, identified problems, developed strategies for using personal, family, community resources and created individual plan of care.

Outcomes Patients who had not received a firm dementia diagnosis, patients with more severe memory problems, caregivers using the Alzheimer's Association services, and caregivers who were not patient spouses had increased satisfaction with managed care services and decreased care-related strain. Care consultation decreased service utilization and caregiver depression.

Author Bass, D., Clark, P., Looman, W., McCarthy, C. & Eckert, S.