Phone-based care programme reduces mortality in chronically ill older
5 December 2006
Chronically ill older adults who were regularly phoned
by care workers had significantly reduced mortality risk, according to a new
study reported in the latest online issue of Health Services Research.(1)
The study involved 781 adults age 65 and older with chronic health care
conditions who were enrolled in the US Medicare programme. 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
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
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
“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.
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
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.
Alkema GE, et al. Reduced mortality: The unexpected impact of a
telephone-based care management intervention for older adults in managed
care. Health Research Services online, 2006.