Impact of the care coordination program “Partners in Dementia Care” on veterans' hospital admissions and emergency department visits

• Published in: Alzheimer's & dementia : translational research & clinical interventions Vol. 1; no. 1; pp. 13 - 22
• Main Authors: Bass, David M, Judge, Katherine S, Maslow, Katie, Wilson, Nancy L, Morgan, Robert O, McCarthy, Catherine A, Looman, Wendy J, Snow, A. Lynn, Kunik, Mark E
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2015; Elsevier
• Subjects: Care-coordination; Hospital and ED use; Neurology; Other; Partnering VA medical centers and community agencies; Support for veterans and caregivers; Telephone and computer support; Veteran outcomes; Hospital and ED use; Partnering VA medical centers and community agencies; Care-coordination; Telephone and computer support; Veteran outcomes; Support for veterans and caregivers
• ISSN: 2352-8737; 2352-8737
• DOI: 10.1016/j.trci.2015.03.003

Abstract Introduction “Partners in Dementia Care” (PDC) tested a care-coordination program based on partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association chapters. The hypothesis posited PDC would reduce the likelihood and number of veterans' hospital admissions and emergency department (ED) visits, particularly for those with more cognitive impairment or behavioral symptoms. Methods The sample included 328 veterans with dementia and their primary family or friend caregivers from five matched sites (two randomly selected treatment sites). Data came from VA records; supplemented by caregiver research interviews. Regression analyses using the likelihood and number of hospital and ED visits as outcomes tested for overall treatment-comparison group differences and statistical interactions with cognitive impairment and behavioral symptoms. Results Consistent with the hypothesis, three significant interactions showed treatment-group veterans, with more cognitive impairment and behavioral symptoms, had fewer hospital admissions and ED visits than comparison-group veterans. There were no differences in the likelihood of hospital or ED use. Discussion PDC, a low-cost program for veterans and caregivers, was effective in reducing the number, but not the likelihood, of hospital admissions and ED visits. Reductions in service use were greater when caregivers reported more difficulties with veterans' symptoms, which in the absence of PDC would place veterans at risk of being high-volume, high-cost service users. Clinical Trial Registration: ClinicalTrials.gov : NCT00291161.