Case managed community aged care: what is the evidence for effects on service use and costs?

OBJECTIVE

To evaluate the effects of case management in community aged care (CMCAC) interventions on service use and costs.

METHOD

Five databases were searched from inception to 2011 July to include randomized control trials and comparative observational English studies. Results were summarized by using the best-evidence synthesis approach.

RESULTS

Twenty-one studies were included. Available studies supported improvements in clients' use of case management services (all of the four studies), some community services (8 of the 10) and nursing home admission and stay (around one half), delay of nursing home placement (all of the two studies), and achieving cost neutrality (8 of the 11). The effects on medical care utilization were varying.

DISCUSSION

In general, these positive effects justify the further development and refinement of CMCAC programs. Result applicability is limited by only including English studies. Cost studies applying a societal perspective, and full economic appraisals where appropriate are warranted.