Zimmer J G, Eggert G M, Chiverton P
University of Rochester School of Medicine and Dentistry.
J Aging Health. 1990 Aug;2(3):357-72. doi: 10.1177/089826439000200305.
Secondary analyses of a randomized trial comparing two models of case management of community residing chronically ill elderly showed that the greatest cost savings of the more intensive neighborhood-based team model, as opposed to the centralized individual model, were in the group with dementia. Estimated costs of health care in the team group were 41% lower than costs for the control group. No differences in survivorship, functional and care need status, or in caregiver satisfaction were found, suggesting no negative effect of reduction in use. Team case managers had much smaller caseloads, made many more home visits, (with much more counseling for family support), and made more referrals for medical evaluation, respite, and day care than did case managers for the control group.
一项比较两种针对社区慢性病老年患者的病例管理模式的随机试验的二次分析表明，与集中式个体模式相比，基于邻里关系的更密集团队模式最大的成本节省体现在痴呆症患者群体中。团队模式组的医疗保健估计成本比对照组低41%。在生存率、功能和护理需求状况或护理人员满意度方面未发现差异，这表明使用量减少没有负面影响。与对照组的个案经理相比，团队个案经理的工作量要小得多，进行的家访要多得多（提供更多关于家庭支持的咨询），并为医疗评估、临时护理和日托提供更多转诊。
