Joshua Chodosh1, Benjamin A Colaiaco2, Karen Ilene Connor3, Dennis Wesley Cope4, Hangsheng Liu5, David Avram Ganz6, Mark Jason Richman4, Debra Lynn Cherry7, Joseph Moshe Blank4, Raquel Del Pilar Carbone8, Sheldon Mark Wolf4, Barbara Grace Vickrey6. 1. University of California, Los Angeles, USA Veteran Affairs Greater Los Angeles Healthcare System, CA, USA RAND Corporation, Santa Monica, CA, USA JChodosh@mednet.ucla.edu. 2. RAND Corporation, Santa Monica, CA, USA. 3. University of California, Los Angeles, USA Veteran Affairs Greater Los Angeles Healthcare System, CA, USA. 4. University of California, Los Angeles, USA Olive View-UCLA Medical Center, Los Angeles, USA. 5. RAND Corporation, Santa Monica, CA, USA RAND Corporation, Boston, MA, USA. 6. University of California, Los Angeles, USA Veteran Affairs Greater Los Angeles Healthcare System, CA, USA RAND Corporation, Santa Monica, CA, USA. 7. University of California, Los Angeles, USA Alzheimer's Association, Los Angeles, CA, USA University of Southern California, Los Angeles, USA. 8. Veteran Affairs Greater Los Angeles Healthcare System, CA, USA.
Abstract
OBJECTIVES: To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia. METHODS: We randomized 151 patient-caregiver dyads from an underserved predominantly Latino community to two arms that shared acare management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient-caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up. RESULTS:Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver. DISCUSSION: Dementiacare quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected.
RCT Entities:
OBJECTIVES: To compare the effectiveness and costs of telephone-only approach to in-person plus telephone for delivering an evidence-based, coordinated care management program for dementia. METHODS: We randomized 151 patient-caregiver dyads from an underserved predominantly Latino community to two arms that shared a care management protocol but implemented in different formats: in-person visits at home and/or in the community plus telephone and mail, versus telephone and mail only. We compared between-arm caregiver burden and care-recipient problem behaviors (primary outcomes) and patient-caregiver dyad retention, care quality, health care utilization, and costs (secondary outcomes) at 6- and 12-months follow-up. RESULTS: Care quality improved substantially over time in both arms. Caregiver burden, care-recipient problem behaviors, retention, and health care utilization did not differ across arms but the in-person program cost more to deliver. DISCUSSION: Dementia care quality improved regardless of how care management was delivered; large differences in effectiveness or cost offsets were not detected.
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