Home > Promising Practices > The Effect of Guided Care Teams on the Use of Health Services

The Effect of Guided Care Teams on the Use of Health Services

An Evidence-Based Practice

Description

This study aimed to investigate the affects of guided care on health care utilization with adults over 65 with multiple chronic conditions who were at high risk of health care use. The program randomized eligible patients into two groups: one receiving guided care and one receiving usual care. The patients were observed for a 20-month period between November 2006 and June 2008. Patients receiving guided care were provided with a guided care nurse who administered eight services in conjunction with the patients primary care physician: comprehensive assessment, evidence-based care planning, monthly monitoring of symptoms and adherence, transitional care, coordination of health care professionals, support for self-management, support for family caregivers, and enhanced access to community services.The study measured the frequency of use of emergency departments, hospitals, skilled nursing facilities, home health agencies, primary care physician services, and specialty physician services.

Goal / Mission

The goal of this study was to determine the effect of interdisciplinary primary care teams on health care utilization by patients with multiple chronic conditions.

Impact

This study concluded that guided care models can significantly impact home health care episodes.

Results / Accomplishments

There was a 30% reduction in episodes of home health care with patients in the intervention group, a statistically significant effect.

About this Promising Practice

Primary Contact
Chad Boult
Department of Health Policy and Management
Johns Hopkins Bloomberg School of Public Health
624 N Broadway
Baltimore, MD 21205
tnovak@jhsph.edu
Topics
Health / Health Care Access & Quality
Date of publication
3/14/2011
Date of implementation
11/1/2006
For more details
https://jamanetwork.com/journals/jamainternalmedic...
Target Audience
Adults, Older Adults

Related Promising Practices

  1. Chronic Disease Self-Management Program
  2. Chronic Disease Self-Managment Education in a Recreation Setting
  3. Reducing Emergency Department Visits and Hospitalizations Through Community Health Workers Integrated Into Primary Care: A Cost-Benefit Analysis
  4. Tomando Control de su Salud (Spanish Chronic Disease Self-Management Program)
  5. Managing Multiple Chronic Conditions with a Community Health Worker Intervention
  6. Pasos Adelante

More

Related Content for: The Effect of Guided Care Teams on the Use of Health Services

An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.