CASE-MANAGEMENT, CLIENT RISK-FACTORS, AND SERVICE USE

Six ''pure'' types of case-manager activity are identified using chart data from 922 cases in the Medicare Alzheimer's Disease Demonstration . The association between case-manager actions and client characterist ics, and between case-manager activities and service use outcomes is u sed to test predictive validity. Case-manager activity is generally mo re associated with caregiver than client characteristics. Monitoring a nd service management was protective against nursing home placement. A clinical nursing emphasis was protective against hospitalization. Und erstanding how case management is differentiated may improve staffing, treatment protocol, and client service outcomes.