Utilization and Cost Effects of the VHA Caring for Older Adults and Caregivers at Home (COACH) Program

Song, Wei; Intrator, Orna; Twersky, Jack; Davagnino, Judith; Kinosian, Bruce; Wieland, Darryl

doi:10.1177/1077558720929592

Cited by 5 publications

(15 citation statements)

References 31 publications

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“…There was wide variability in how cost was measured from actual costs available in the claims data (e.g., Medicare claims) to an average cost assigned based on available data reported for a given year (e.g., Healthcare Cost and Utilization Project 90 ). Often interventions targeting transitions in care and care coordination examine costs of the intervention as well as the cost of the acute and post‐acute care services 27,43,44,48,50,53,56,70,81–85 …”

Section: Resultsmentioning

confidence: 99%

“…Among the 71 reports, 60 included 16 measures of transitional care and care coordination outcomes related to the person living with dementia and caregivers (see Table 1). Care transitions and care coordination outcomes measures primarily focus on health‐care use ( n = 48; e.g., acute care, post‐acute care, ambulatory care, long‐term care) 15,16,24,25,27,28,30,31,34,40–80 and cost outcomes ( n = 12) 43,44,48,50,53,56,70,81–85 . Mortality was also a common outcome measure in care transitions and care coordination studies ( n = 14) 26,27,34,40,42,46,49,60,64,65,67,68,85,86 .…”

Section: Resultsmentioning

confidence: 99%

“…Care transitions and care coordination outcomes measures primarily focus on health-care use (n = 48; e.g., acute care, post-acute care, ambulatory care, long-term care) 15,16,24,25,27,28,30,31,34, and cost outcomes (n = 12). 43,44,48,50,53,56,70,[81][82][83][84][85] Mortality was also a common outcome measure in care transitions and care coordination studies (n = 14). 26,27,34,40,42,46,49,60,64,65,67,68,85,86 Below each type is described.…”

Section: Transitional Care and Care Coordination Outcomesmentioning

confidence: 99%

“…• Respite (e.g., in home respite use 44,88 ; overnight respite care 44 ; respite care nights (count) 44 ) • Combination of services (e.g., meals, homemaker, respite, personal care assistance 15,46,48,70 Long-term care use • Single item (e.g., long-term care placement 30,[40][41][42]44,45,48,49,51,53,59,67,68,70,72,73,78,80 ; time to long-term care placement 42,46,47,50,52,53,55,58,60,61,85,89 ; length of long-term care placement 79 ; change in long-term care facility status 54 ; risk of eviction 54 ; prevented evictions 54 ) • Multi-item scale (e.g., anticipated plans to institutionalize) 57,71 • National health care or insurance database…”

Section: Medicalmentioning

confidence: 99%

“…Often interventions targeting transitions in care and care coordination examine costs of the intervention as well as the cost of the acute and post-acute care services. 27,43,44,48,50,53,56,70,[81][82][83][84][85] Mortality was frequently measured in studies that explored transitional care and care coordination. Twelve reports measured rate of death or time to death via EHR, caregiver report, or a national registry.…”

Section: Transitional Care and Care Coordination Outcomesmentioning

confidence: 99%

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An integrative review of measures of transitions and care coordination for persons living with dementia and their caregivers

Hirschman

McHugh

Morgan

2023

A&D Transl Res & Clin Interv

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IntroductionHigh rates of hospital visits and readmissions are common among persons living with dementia, resulting in frequent transitions in care and care coordination. This paper identifies and evaluates existing measures of transitions and care coordination for persons living with dementia and their caregivers.MethodsThis integrative review builds off a prior review using a systematic search of online databases (PubMed, EBSCO, CINAHL, PsycInfo, and Scopus) to identify records and locate reports (or articles) that use measures of care transitions and care coordination. Identified measures were compared to the Alzheimer's Association's Dementia Care Practice Recommendations to evaluate strengths and weaknesses of the measure in this population, such as if measures were person‐ and family‐centered.ResultsSeventy‐one reports using measures of transitions in care and care coordination for persons living with dementia and their caregivers were identified. There were multiple measures identified in some reports. Three main areas of measures were classified into: identification of the population (3 measures, 8 reports), transitional care and care coordination delivery (14 measures, 17 reports), and transitional care and care coordination outcomes (e.g., health‐care use, cost, and mortality; 17 measures, 60 reports). A strength of the three main areas of measures was that a portion of the measures were person‐ and family‐centered. Variability in the operational definitions of some measures and time intensiveness of collecting the measure (e.g., number of items, the time it takes to complete the items) were common weaknesses.DiscussionTransitions and care coordination measures are varied across studies targeted at persons living with dementia and their caregivers. Existing measures focus heavily on outcomes, specifically health‐care resource use, and cost, rather than the elements of transitional care or care coordination. Future measure development focused on care transitions and service coordination is needed.

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Section: Resultsmentioning

confidence: 99%