Skip to main content
Top
Published in: BMC Geriatrics 1/2014

Open Access 01-12-2014 | Research article

Towards personalized integrated dementia care: a qualitative study into the implementation of different models of case management

Authors: Lisa D Van Mierlo, Franka JM Meiland, Hein PJ Van Hout, Rose-Marie Dröes

Published in: BMC Geriatrics | Issue 1/2014

Login to get access

Abstract

Background

The aim of this process evaluation was to provide insight into facilitators and barriers to the delivery of community-based personalized dementia care of two different case management models, i.e. the linkage model and the combined intensive case management/joint agency model. These two emerging dementia care models differ considerably in the way they are organized and implemented. Insight into facilitators and barriers in the implementation of different models is needed to create future guidelines for successful implementation of case management in other regions.

Methods

A qualitative case study design was used; semi-structured interviews were conducted with 22 stakeholders on the execution and continuation phases of the implementation process. The stakeholders represented a broad range of perspectives (i.e. project leaders, case managers, health insurers, municipalities).

Results

The independence of the case management organization in the intensive model facilitated the implementation, whereas the presence of multiple competing case management providers in the linkage model impeded the implementation. Most impeding factors were found in the linkage model and were related to the organizational structure of the dementia care network and how partners collaborate with each other in this network.

Conclusions

The results of this process evaluation show that the intensive case management model is easier to implement as case managers in this model tend to be more able to provide quality of care, are less impeded by competitiveness of other care organizations and are more closely connected to the expert team than case managers in the linkage model.
Appendix
Available only for authorised users
Literature
1.
go back to reference Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness. JAMA. 2002, 14: 1775-1779.CrossRef Bodenheimer T, Wagner EH, Grumbach K: Improving primary care for patients with chronic illness. JAMA. 2002, 14: 1775-1779.CrossRef
3.
go back to reference Somme D, Trouve H, Dram M, Gagnon D, Couturier Y, Saint-Jean O: Analysis of case management programs for patients with dementia: a systematic review. Alzheimers Dement. 2012, 8: 426-436. 10.1016/j.jalz.2011.06.004.CrossRefPubMed Somme D, Trouve H, Dram M, Gagnon D, Couturier Y, Saint-Jean O: Analysis of case management programs for patients with dementia: a systematic review. Alzheimers Dement. 2012, 8: 426-436. 10.1016/j.jalz.2011.06.004.CrossRefPubMed
5.
go back to reference Pimouguet C, Lavaud T, Dartigues JF, Helmer C: Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. J Nutr Health Aging. 2010, 14: 669-676. 10.1007/s12603-010-0314-4.CrossRefPubMed Pimouguet C, Lavaud T, Dartigues JF, Helmer C: Dementia case management effectiveness on health care costs and resource utilization: a systematic review of randomized controlled trials. J Nutr Health Aging. 2010, 14: 669-676. 10.1007/s12603-010-0314-4.CrossRefPubMed
6.
go back to reference Koch T, Iliffe S, Manthorpe J, Stephens B, Fox C, Robinson L, Livingston G, Coulton S, Knapp M, Chew-Graham C, Katona C: The potential of case management for people with dementia: a commentary. Int J Geriatr Psychiatry. 2012, 27: 1305-1314. 10.1002/gps.3783.CrossRefPubMed Koch T, Iliffe S, Manthorpe J, Stephens B, Fox C, Robinson L, Livingston G, Coulton S, Knapp M, Chew-Graham C, Katona C: The potential of case management for people with dementia: a commentary. Int J Geriatr Psychiatry. 2012, 27: 1305-1314. 10.1002/gps.3783.CrossRefPubMed
8.
go back to reference Minkman MM, Ligthart SA, Huijsman R: Integrated dementia care in The Netherlands: a multiple case study of case management programs. Health Soc Care Community. 2009, 17: 485-494. 10.1111/j.1365-2524.2009.00850.x.CrossRefPubMed Minkman MM, Ligthart SA, Huijsman R: Integrated dementia care in The Netherlands: a multiple case study of case management programs. Health Soc Care Community. 2009, 17: 485-494. 10.1111/j.1365-2524.2009.00850.x.CrossRefPubMed
9.
go back to reference MacNeil Vroomen J, Van Mierlo LD, Van de Ven PM, Bosmans JE, Van den Dungen P, Meiland FJM, Dröes RM, van Charante EP M, Van der Horst HE, De Rooij SE, Van Hout HPJ: Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study. BMC Health Serv Res. 2012, 12: 132-10.1186/1472-6963-12-132.CrossRefPubMedPubMedCentral MacNeil Vroomen J, Van Mierlo LD, Van de Ven PM, Bosmans JE, Van den Dungen P, Meiland FJM, Dröes RM, van Charante EP M, Van der Horst HE, De Rooij SE, Van Hout HPJ: Comparing Dutch Case management care models for people with dementia and their caregivers: The design of the COMPAS study. BMC Health Serv Res. 2012, 12: 132-10.1186/1472-6963-12-132.CrossRefPubMedPubMedCentral
10.
go back to reference Banks P: Case management. Integrating services for older people – a resource book for managers. Edited by: Berman NPC. 2004, Dublin: EHMA, 101-112. Banks P: Case management. Integrating services for older people – a resource book for managers. Edited by: Berman NPC. 2004, Dublin: EHMA, 101-112.
11.
go back to reference Meiland FJ, Dröes RM, De Lange J, Vernooij-Dassen MJ: Development of a theoretical model for tracing facilitators and barriers in adaptive implementaion of innovative practices in dementia care. Arch Gerontol Geriatr. 2004, 9 (Suppl): 279-290.CrossRef Meiland FJ, Dröes RM, De Lange J, Vernooij-Dassen MJ: Development of a theoretical model for tracing facilitators and barriers in adaptive implementaion of innovative practices in dementia care. Arch Gerontol Geriatr. 2004, 9 (Suppl): 279-290.CrossRef
12.
go back to reference Verkaik R, Francke AL, van Meijel B, Ouwerkerk J, Ribbe MW, Bensing JM: Introducing a nursing guideline on depression in dementia: a multiple case study on influencing factors. Int J Nurs Stud. 2011, 48: 1129-1139. 10.1016/j.ijnurstu.2011.02.009.CrossRefPubMed Verkaik R, Francke AL, van Meijel B, Ouwerkerk J, Ribbe MW, Bensing JM: Introducing a nursing guideline on depression in dementia: a multiple case study on influencing factors. Int J Nurs Stud. 2011, 48: 1129-1139. 10.1016/j.ijnurstu.2011.02.009.CrossRefPubMed
13.
go back to reference Grol R, Wensing M: Implementatie: effectieve verbetering in de patientenzorg. Implementation: effective improvements in patient care. In Dutch. 2011, Amsterdam: Reed Business, Fourth, revised Grol R, Wensing M: Implementatie: effectieve verbetering in de patientenzorg. Implementation: effective improvements in patient care. In Dutch. 2011, Amsterdam: Reed Business, Fourth, revised
15.
go back to reference Dröes RM, Meiland FJM, Schmitz MJ, Vernooij-Dassen MJFJ, De Lange J, Derksen E, Boerema I, Grol RPTM, Van Tilburg W: Implementatiemodel ontmoetingscentra; een onderzoek naar de voorwaarden voor succesvolle landelijke implementatie van ontmoetingscentra voor mensen met dementie en hun verzorgers. Eindrapport. Implementation meeting centres model; a study into the conditions of succesfull national implementation of meeting centres for people with dementia and their carers. Final report. 2003, Amsterdam: Department of Psychiatry, VU Medical Center Dröes RM, Meiland FJM, Schmitz MJ, Vernooij-Dassen MJFJ, De Lange J, Derksen E, Boerema I, Grol RPTM, Van Tilburg W: Implementatiemodel ontmoetingscentra; een onderzoek naar de voorwaarden voor succesvolle landelijke implementatie van ontmoetingscentra voor mensen met dementie en hun verzorgers. Eindrapport. Implementation meeting centres model; a study into the conditions of succesfull national implementation of meeting centres for people with dementia and their carers. Final report. 2003, Amsterdam: Department of Psychiatry, VU Medical Center
16.
go back to reference Meiland FJM, Dröes RM, de Lange J, Vernooij-Dassen MJFJ: Facilitators and barriers in the implementation of the meeting centres model for people with dementia and their carers. Health Policy. 2005, 71: 243-253. 10.1016/j.healthpol.2004.08.011.CrossRefPubMed Meiland FJM, Dröes RM, de Lange J, Vernooij-Dassen MJFJ: Facilitators and barriers in the implementation of the meeting centres model for people with dementia and their carers. Health Policy. 2005, 71: 243-253. 10.1016/j.healthpol.2004.08.011.CrossRefPubMed
17.
go back to reference Yin RK: Case study research: Design and methods. 2003, Thousand Oaks, CA: Sage, 3 Yin RK: Case study research: Design and methods. 2003, Thousand Oaks, CA: Sage, 3
18.
go back to reference Barbour RS: The case for combining qualitative and quantitative approaches in health services research. J Health Serv Res Policy. 1999, 4: 39-43.PubMed Barbour RS: The case for combining qualitative and quantitative approaches in health services research. J Health Serv Res Policy. 1999, 4: 39-43.PubMed
19.
go back to reference Atlas-ti: ATLAS.Ti Version 5.2, 2008. 2012, Berlin: Scientific Software Development GmbH Atlas-ti: ATLAS.Ti Version 5.2, 2008. 2012, Berlin: Scientific Software Development GmbH
20.
go back to reference Hsieh H, Shannon SE: Three approaches to qualitative content analysis. Qual Health Res. 2005, 15: 1277-1288. 10.1177/1049732305276687.CrossRefPubMed Hsieh H, Shannon SE: Three approaches to qualitative content analysis. Qual Health Res. 2005, 15: 1277-1288. 10.1177/1049732305276687.CrossRefPubMed
21.
go back to reference Guba EG: Criteria for assessing the trustworthiness of naturalistic inquiries. Educ Technol Res Dev Annual Review Paper. 1981, 29: 75-91. Guba EG: Criteria for assessing the trustworthiness of naturalistic inquiries. Educ Technol Res Dev Annual Review Paper. 1981, 29: 75-91.
22.
go back to reference Verkade PJ, van Meijel B, Brink C, van Os-Medendorp H, Koekkoek B, Francke AL: Delphi research exploring essential components and preconditions for case management in people with dementia. BMC Geriatr. 2010, 9: 10-54. Verkade PJ, van Meijel B, Brink C, van Os-Medendorp H, Koekkoek B, Francke AL: Delphi research exploring essential components and preconditions for case management in people with dementia. BMC Geriatr. 2010, 9: 10-54.
23.
go back to reference Pacala JT, Boult C, Hepburn KW, Kane RA, Kane RL, Malone JK, Morishita L, Reed RL: Case management of older adults in health maintenance organizations. J Am Geriatr Soc. 1995, 43: 538-542.CrossRefPubMed Pacala JT, Boult C, Hepburn KW, Kane RA, Kane RL, Malone JK, Morishita L, Reed RL: Case management of older adults in health maintenance organizations. J Am Geriatr Soc. 1995, 43: 538-542.CrossRefPubMed
24.
go back to reference Boekholdt M, Pepels R: Implementation: introducing innovations in the field of care for the elderly. Innovation Work in the Field of Care for the Elderly in Practice. Edited by: Nies H, Kollaard S. 1994, Houten/Zaventem: Bohn, Stafleu Van Lochum, in Dutch Boekholdt M, Pepels R: Implementation: introducing innovations in the field of care for the elderly. Innovation Work in the Field of Care for the Elderly in Practice. Edited by: Nies H, Kollaard S. 1994, Houten/Zaventem: Bohn, Stafleu Van Lochum, in Dutch
25.
go back to reference Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003, 362: 1225-1230. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003, 362: 1225-1230. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed
Metadata
Title
Towards personalized integrated dementia care: a qualitative study into the implementation of different models of case management
Authors
Lisa D Van Mierlo
Franka JM Meiland
Hein PJ Van Hout
Rose-Marie Dröes
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-14-84

Other articles of this Issue 1/2014

BMC Geriatrics 1/2014 Go to the issue