December 15, 2008

Patient-centered elder care effective

A patient-centered program using nurse care managers and computer tools reduces deaths and hospitalizations of the chronically ill, U.S. researchers said.

A three-year study involving more than 3,400 chronically ill seniors was conducted between Jan. 1, 2002, and June 30, 2005, at 13 primary care clinics in Utah.

The study, published in the Journal of the American Geriatrics Society, found that deaths among the 1,144 patients in the intervention group receiving optimum care, called Care Management Plus, were significantly lower in the first and second years than among the 2,288 patients in the control group whose members received the usual care.

Dr. David A. Dorr of the Oregon Health & Science University in Portland, Ore., said patients coping with two chronic health conditions are eight times as likely to die within a year as peers with one such illness.

Someone with three or more chronic illnesses has 40 times higher odds of being hospitalized than a person with a single chronic illness and 91 times higher odds than someone with no such illness, Dorr said in a statement. Chronic conditions account for 83 percent of all healthcare spending and the majority of cost increases in Medicare are due to patients with five or more chronic illnesses.

In the intervention group, patients were referred to a nurse care manager who completed a patient assessment focused on self-efficacy, knowledge, readiness to change and patient-directed goal setting. The care manager created a detailed care plan using specialized computer tools.