NUTRITION AND HEALTH FOR OLDER PERSONS IN RURAL AMERICA - A MANAGED CARE MODEL

Citation
Gl. Klein et al., NUTRITION AND HEALTH FOR OLDER PERSONS IN RURAL AMERICA - A MANAGED CARE MODEL, Journal of the American Dietetic Association, 97(8), 1997, pp. 885-888
Citations number
10
Categorie Soggetti
Nutrition & Dietetics
ISSN journal
00028223
Volume
97
Issue
8
Year of publication
1997
Pages
885 - 888
Database
ISI
SICI code
0002-8223(1997)97:8<885:NAHFOP>2.0.ZU;2-6
Abstract
Health care services and resources for older persons living in rural a reas may be highly variable, and integrated service-delivery models ar e often lacking. This article presents a managed-care model of nutriti on risk screening and intervention for older persons in rural areas. N utrition risk screening was implemented by the Geisinger Health Care S ystem, Danville, Pa, to target all eligible enrollees in a regional Me dicare risk program. A single remote clinic site participating in the managed health care system was chosen for further study of a linked sc reening and case-management effort for undernourished persons. Screeni ng and intervention at the clinic site selected for this study were gu ided by centralized expertise and resources. Individualized evaluation and intervention plans were developed with the aid of a dietitian and implemented by the clinic case manager. Of the 417 subjects who compl eted screening at the remote site, 68 met the risk criteria for undern utrition and were selected for case management. Many of the targeted p ersons received interventions that included evaluations by a physician or physician extender (eg, physician assistant, nurse practitioner) a t the clinic and consultations with nutrition, mental health, or socia l services professionals. Twenty-six of the subjects who took part in the intervention completed a follow-up screening 6 months later. Ten o f those persons no longer exhibited risk criteria. This demonstrates t he feasibility of a linked screening and case management program for n utrition risk in the managed-care setting.