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Research Transfer > System-Linked Research Unit Working Paper Series #93-14
   

93-14

System-Linked Research Unit
Working Paper Series #93-14

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 Back to TopLong-Term Care Reform agenda in the future.

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