Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
J Am Geriatr Soc. 2012 Jan;60(1):86-92. doi: 10.1111/j.1532-5415.2011.03763.x.
To determine the effect of a primary care-based care management initiative on residential care placement and death in a population of frail older adults referred for needs assessment in New Zealand.
Randomized controlled trial with follow-up at 3, 6, 12, 18, and 24 months for residential care placement and mortality.
Fifty-five family physician practices in New Zealand that established a care management initiative for older adults assessed as being at high risk of residential care placement in 2004 to 2006.
Three hundred fifty-one individuals (243 female, 108 male) aged 65 and older (mean 81) who were assessed as being at risk of permanent residential care placement.
The care management program (Coordinator of Services for Elderly) consisted of a nominated health professional care manager geographically aligned to family physicians housed with the family physician or located nearby.
Rates of permanent residential care placement and mortality.
The risk of permanent residential care placement or death was 0.36 for usual care (control group) and 0.26 for the care management initiative, a 10.2% absolute risk reduction, with the majority of the risk reduction seen in residential care placement (control group 0.25, intervention group 0.16).
A family physician-aligned community care management approach reduces frail older adults' risk of mortality and permanent residential care placement.
确定初级保健为基础的护理管理计划对新西兰接受需求评估的体弱老年人的居住护理安置和死亡的影响。
随机对照试验，随访时间为 3、6、12、18 和 24 个月，以评估居住护理安置和死亡率。
新西兰的 55 个家庭医生诊所，这些诊所于 2004 年至 2006 年为被评估为有居住护理安置高风险的老年人设立了护理管理计划。
351 名年龄在 65 岁及以上（平均 81 岁）的个体（243 名女性，108 名男性），他们被评估为有永久性居住护理安置的风险。
护理管理计划（老年服务协调员）由指定的卫生专业护理经理组成，该经理在地理上与家庭医生保持一致，与家庭医生一起或附近办公。
永久性居住护理安置和死亡率的发生率。
常规护理（对照组）的永久居住护理安置或死亡风险为 0.36，而护理管理计划的风险为 0.26，绝对风险降低了 10.2%，其中大部分风险降低发生在居住护理安置（对照组为 0.25，干预组为 0.16）。
家庭医生一致的社区护理管理方法降低了体弱老年人的死亡率和永久性居住护理安置风险。
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