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A RANDOM CONTROLLED
TRIAL OF THE COSTS, EFFECTS, AND BENEFITS OF AN INTERAGENCY RISK
MANAGEMENT TEAM
L. Cox, G. Browne
Background:
Studies show that lack of coordination in health care for elderly
people is a main reason for fragmentation of their community services.
It has also been identified that health professionals involved with
seniors required increased awareness of community resources and
services.
Purpose:
To document the effectiveness of a unique interagency service alliance
called the 'Community Resource Group in Geriatrics Consultation
Team' (CRG) with a random controlled trial with both qualitative
and quantitative analyses.
Setting:
The CRG offers advice to community health care providers with high-risk
elderly clients and their families. Fifteen providers and caregivers
were studied, seven in the experimental group and eight in the control
group.
Findings:
(1) This
pilot project demonstrated that the CRG consultation team intervention
as an educational strategy does increase the provider's confidence
in managing high-risk cases as compared to providers who received
traditional agency supervision. Consultation also decreased the
providers' rating of risk compared to ratings of providers who received
conventional agency supervision.
This improvement was associated with greatly
reduced caregiver burden as compared to the control group. Caregivers
experienced a great deal of stress and burden but found their role
to be moderately manageable, coherent, and meaningful.
(2) Use
of health services increased after the CRG intervention. The hypothesis
of cost benefit was not supported; the CRG Experimental client group
deteriorated in social resources, while the Control client groups
improved in resources. Social resources are the most important determinant
of utilization of services. Therefore no important decision should
be based on this study due to small sample size and variation in
client groups. However, a model such as the CRG was supported in
several different sets of literature and previous research. Such
a model would be appropriate in the Multi-Service Agencies which
are part of the Long-Term
Care Reform agenda in the future.
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