Client outcomes in case managed care: Who benefits most?

Objective: To determine how well outcomes could be predicted by initial cir cumstances and subsequent deterioration in clients and carers. Method: Longitudinal data from the Victorian Linkages projects, collected i n 1992 and 1994, were examined. Results: Institutionalisation was highly likely in eases where carers exper ienced reduced motivation to care. Placement in nursing homes rather than i n hostels was best predicted by incontinence. Death was associated with cha nges in health status. Those clients most successful in avoiding long-term institutional care were in stable situations with a spouse carer. Conclusion: The study provides supportive evidence of the capacity of inten sive community services to provide alternatives to entry to residential car e.