Case management and risk of nursing home admission for older adults in home care: results of the AgeD in HOme Care Study.

Objectives: To explore the relationship between a case management approach and the risk of institutionalization in a large European population of frail, old people in home care.

Design: Retrospective cohort study.

Setting: Eleven European countries.

Participants: Three thousand two hundred ninety-two older adults receiving home care (mean age 82.3+/-7.3).

Measurements: Data on nursing home admission were collected every 6 months for 1 year.

Results: One thousand one hundred eighty-four (36%) persons received a home care program based on case management, and 2,108 (64%) received a traditional care approach (no case manager). During the 1-year follow-up, 81 of 1,184 clients (6.8%) in the case management group and 274 of 2,108 (13%) in the traditional care group were admitted to a nursing home (P<.001). After adjusting for potential confounders, the risk of nursing home admission was significantly lower for participants in the case management group than for those in a traditional care model (adjusted odds ratio=0.56, 95% confidence interval=0.43-0.63).

Conclusion: Home care services based on a case management approach reduce risk of institutionalization and likely lower costs.