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BMC Health Services Research
Published in: BMC Health Services Research 1/2011

Open Access 01-12-2011 | Research article

A systematic review of different models of home and community care services for older persons

Authors: Lee-Fay Low, Melvyn Yap, Henry Brodaty

Published in: BMC Health Services Research | Issue 1/2011

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Abstract

Background

Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including those with dementia.

Methods

A systematic review was conducted of non-medical home and community care services for frail older persons. MEDLINE, PsycINFO, CINAHL, AgeLine, Scopus and PubMed were searched from 1994 to May 2009. Two researchers independently reviewed search results.

Results

Thirty five papers were included in this review. Evidence from randomized controlled trials showed that case management improves function and appropriate use of medications, increases use of community services and reduces nursing home admission. Evidence, mostly from non-randomized trials, showed that integrated care increases service use; randomized trials reported that integrated care does not improve clinical outcomes. The lowest quality evidence was for consumer directed care which appears to increase satisfaction with care and community service use but has little effect on clinical outcomes. Studies were heterogeneous in methodology and results were not consistent.

Conclusions

The outcomes of each model of care differ and correspond to the model's focus. Combining key elements of all three models may maximize outcomes.
Appendix
Available only for authorised users
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Metadata
Title
A systematic review of different models of home and community care services for older persons
Authors
Lee-Fay Low
Melvyn Yap
Henry Brodaty
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2011
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-11-93

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