A telephone-based program linking chronically ill older adults to home or community services significantly reduces mortality risk, according to a new study.//
“It’s not just medical or social services, but bridging those two together,” said lead author Gretchen Alkema of the Davis School of Gerontology at the University of Southern California in Los Angeles.
The study appears in the latest online issue of Health Services Research.
The study involved 781 adults age 65 and older with chronic health care conditions who were enrolled in Medicare. After undergoing a detailed assessment of their health and functional needs, half of the adults received advice and referrals to in-home care, nutrition, home safety, transportation and other supportive services not covered by their health plan.
Social workers called “care advocates” phoned the treatment participants monthly for the next year to assist them in making care arrangements. Participants were encouraged to call the care advocates at any time to ask questions.
The results showed that during the 12-month active study period, the telephone program participants had about the half the risk of death, compared to older adults who didn’t receive personalized telephone services.
“The care advocate model allowed consumers to be educated about and gain access to a variety of home- and community-based services as well as being redirected back to health care when needed. Older adults are much more plugged into the health care system, rather than having knowledge of community-based services,” Alkema said.
Many participants spontaneously said that “they never knew these services existed,” Alkema said. “This idea of having a professional to bridge those two worlds is really critical, because often issues that affect health care may also have connections in social care services,” Alkema said.
Despite the positive findings, during the year-
long follow-up period, the effect of the program disappeared. Researchers found no difference in mortality risk between the treatment and control groups by 24 months.
“The focus of the study is extremely important,” said Frederick Masoudi, a cardiologist at Denver Health Medical Center.
However, “the thing to keep in mind is that a lot of people are constrained by what their providers and health care plans can provide to them,” said Masoudi, who was not involved with the study.
“If they are offered the opportunity to participate in a program that will allow them to have frequent monitoring, they should consider that strongly. Unfortunately, it’s not necessarily available to all people,” he said.
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