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The Gerontologist 43:73-85 (2003)
© 2003 The Gerontological Society of America

The Cleveland Alzheimer's Managed Care Demonstration: Outcomes After 12 Months of Implementation

David M. Bass, PhD1,, Patricia A. Clark, MA1, Wendy J. Looman1, Catherine A. McCarthy1 and Sharen Eckert, MS2

Correspondence: Address correspondence to David M. Bass, Benjamin Rose, 850 Euclid Avenue, Suite 1100, Cleveland, OH 44114. E-mail: dbass{at}benrose.org

Purpose: This demonstration evaluates the effects of integrating Alzheimer's Association care consultation service with health care services offered by a large managed care system. The primary hypothesis is that Association care consultation will decrease service utilization, increase satisfaction with managed care, and decrease caregiver depression and care-related strain. Secondary modifying-effects hypotheses posit that the effects of the intervention will be intensified when patients have not received a firm dementia diagnosis, patients have more severe memory problems, caregivers use other Association services in tandem with care consultation, and caregivers are not patients' spouses. Design and Methods: The demonstration is a randomized trial that examines outcomes after a 12-month study period. Interview data from 157 primary family caregivers are combined with data abstracted from medical/administrative records. Results: Support for the primary hypothesis is found for selected, but not all, service utilization outcomes and for caregiver depression. Support for secondary modifying-effects hypotheses is found for satisfaction outcomes and care-related strain outcomes. Implications: Care consultation delivered within a partnership between a managed care health system and an Alzheimer's Association is a promising strategy for improving selected outcomes for patients with dementia and their caregivers.




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