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December 11, 2007Geriatric Care Intervention Appears to Provide Some Benefits for Low-Income Seniors |
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From EurekAlert! - Breaking News: A home-based geriatric care program for low-income seniors resulted in higher-quality medical care, improvement in quality of life and fewer emergency department visits, but did not appear to prevent decline in physical functioning, according to a study in the December 12 issue of JAMA. Low-income seniors frequently have chronic medical conditions and limited access to health care. Older adults in general, and especially the poor, often do not receive the recommended standard of care for preventive services and management of chronic diseases. "These patient groups have been understudied in previous trials and represent a complex and high-cost population that might especially benefit from improved coordination and integration of their health care," the authors write. Features of the GRACE intervention include in-home assessment and care management provided by a nurse practitioner and social worker team; extensive use of specific care protocols for evaluation and management of common geriatric conditions; utilization of an integrated electronic medical record and a Web-based care management tracking tool; and integration with affiliated pharmacy, mental health, home health, community-based and inpatient geriatric care services. The participants' primary care physicians were randomized from January 2002 through August 2004 to participate in the intervention (474 patients) or usual care (477 patients) in community-based health centers. Patients received two years of home-based care management by a nurse practitioner and social worker who collaborated with the primary care physician and a geriatrics interdisciplinary team and were guided by 12 care protocols for common geriatric conditions. Under current fee-for-service Medicare, most of the services provided by the GRACE intervention are not reimbursed.
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