Randomized controlled trial of nurse case management of frail older people

J Am Geriatr Soc. 1999 Sep;47(9):1118-24. doi: 10.1111/j.1532-5415.1999.tb05238.x.

Abstract

Objectives: To compare the effects of nurse case management with usual care provided to community-dwelling frail older people in regard to quality of life, satisfaction with care, functional status, admission to hospital, length of hospital stay, and readmission to emergency department.

Design: Randomized controlled trial.

Setting: University hospital and two proximal community health centers.

Participants: 427 frail older people (> or = 70 years of age and at risk for repeated hospital admissions) discharged home from the emergency department.

Experimental: Nurse case management, which consisted of coordination and provision of healthcare services by nurses, both in and out of hospital, for a 10-month period.

Control: Usual care, which varied by healthcare provider and community health center.

Measurements: Outcomes were assessed 10 months post-randomization by telephone and/or home interview and by medical record review. Questionnaires included the SF-36, CSQ-8, and OARS.

Results: No significant differences were found in quality of life, satisfaction with care, functional status, admission to hospital, or length of hospital stay. Nurse-case-managed older adults were readmitted to the emergency department significantly more often than their usual care counterparts.

Conclusions: Frail older people receiving nurse case management are more likely to use emergency health services without a concomitant increase in health benefits.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Case Management*
  • Catchment Area, Health
  • Community Health Nursing*
  • Female
  • Frail Elderly*
  • Geriatric Assessment
  • Health Services for the Aged* / statistics & numerical data
  • Humans
  • Length of Stay
  • Male
  • Patient Readmission
  • Patient Satisfaction*
  • Quality of Life
  • Quebec