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Abstract
Purpose
To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people.
Methods
All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP).
Results
Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410).
Conclusion
Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.
Figures and Tables
Table 2
Comparison of Outcomes between Intervention and Control group
*"Decline" means that score of ADL, IADL, cognitive performance scale, depression rating scale, pain scale and the number of CAPs increased from baseline to follow-up; "Improve" means that score of ADL, IADL, cognitive performance scale, depression rating scale, pain scale and the number of CAPs decreased.
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