Clinical Evidence Supporting our Care Management Model

Less Hospitalizations and Emergency Room visits with Care Management

A study of 226 high-risk, frail elderly patients showed that geriatric care management by nurses and social workers resulted in a decrease of emergency room visits and hospital admissions. Emergency room visits declined from 1,500 visits to 700 visits over a 24-month period in patients who received care management. Hospitalizations also declined when care management was utilized from 800 admissions to 400 admissions over the same 24-month period.
-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2007)

Less agitation in Alzheimer’s patients and less stress in caregivers with collaborative care model

In a study of 153 older adults with Alzheimer's disease and their caregivers, two groups were followed for 18 months. One group received collaborative care, spearheaded by an advanced practice nurse. The control group was not exposed to the team approach to health care, but did receive educational materials on the disease. Conclusion: the decreased patient agitation seen in the care group was directly correlated with lower caregiver stress and fewer depressive symptoms, and was achieved without anti-psychotics or sedatives.
-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2006)

Care coordination, counseling and support improve patient outcomes

In a study of 139 elderly patients with cardiac medical and surgical diagnosis, it was found that the greater the nursing time spent and number of contacts per patient, the better the patient outcome and the lower the healthcare costs. Three interventions were especially valuable: (1) surveillance of symptoms and behaviors; (2) care coordination; and (3) counseling and support.
-JOURNAL OF NURSING SCHOLARSHIP (2003)

Chronic care model shows improved patient outcomes

The chronic care model, a model of care involving multidisciplinary practice teams of 6 to 8 people, including nurses and social workers, each with a “physician champion,” has proven to be effective in improving patient outcomes. This was found by a number of studies of populations with different chronic conditions, including diabetes, asthma, depression and others commonly found in the elderly population.
-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2002)

Benefits of restorative home care versus traditional home care

A study of 1,382 elderly patients that compared restorative home care with traditional home care services. It found that restorative home care, based on principles from geriatric medicine, nursing rehabilitation and goal attainment, was shown to prevent the functional decline that occurs in elderly patients after they are discharged from a hospital.
-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2002)