Expected effectiveness of case management for maintaining frail older persons at home
(2013) 42nd Annual Conference British Society of Gerontology — Location: Oxford, UK (11.September.2013)
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- Abstract
- (en) The Belgian health care system is largely fragmented and not proactive enough to face the increased proportion of frail older persons living with multimorbid conditions. Case management (CM) is expected to be one of the responses to overcome health care system weaknesses. The aim of the research was to study the conditions and the mechanisms through which newly implemented CM projects in Belgium could be effective. Mixed methods were used. Firstly, we compared groups of frail older persons included in CM projects to frail older persons also in home care projects, but without CM. We studied the statistical association between benefiting from a CM project and (health and cost) outcome variables. The main outcome was the risk of institutionalization. Secondly, five case studies were conducted to provide an in-depth analysis of the projects, in order to shed light upon how the CM projects worked (mechanisms), for whom, under which conditions and why (realist approach). Internal and external validity was sought through data, theoretical and methodological triangulation. Findings are related to the conditions under which CM projects are expected to provide positive outcomes, such as case managers' profile and training, the adequacy and acceptability of information flow, the importance of GPs' involvement and the consistency of the CM with the values of both care providers and older persons. The realist approach used in this mixed method design yields robust evidence about the projects components and mechanisms affecting frail older people's outcomes in their specific context.
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Citations
Van Durme, T., Schmitz, O., Cès, S., de Mello Almeida, J., Declercq, A., & Macq, J. (2013). Expected effectiveness of case management for maintaining frail older persons at home. In Oxford Institute of Population Ageing (ed.), Book of abstracts. https://hdl.handle.net/2078.5/219133