A new model of integrated home care for the elderly: impact on hospital use

The objective of the present study was to examine the effect of a home care program based on comprehensive geriatric assessment-Minimum Data Set for H ome Care-and case management on hospital use/cost of frail elderly individu als. We determined all hospital admissions and days spent in hospital durin g the first year since the implementation of the home care program. and com pared them to the rate of hospitalization that the same patients had experi enced in the year preceding the implementation of such program. Following t he implementation of this program, there was a significant reduction of the number of hospitalizations (pre 44% vs. post 26%, P < 0.001), associated w ith a reduction of hospital days, both at the individual patient level and for each admission. In conclusion, an integrated home care program based on the implementation of a comprehensive geriatric assessment instrument guid ed by a case manager has a significant impact on hospitalization and is cos t-effective. (C) 2001 Elsevier Science Inc. All rights reserved.