Preventive home visit model targeted to specific care needs of ambulatory frail elders: preliminary report of a randomized trial design

Abstract

The design's unique elements of regular evaluation of healthcare needs for targeted individuals within the long-term care insurance context will allow new understanding of the role and effectiveness of preventive home visits.

Effects of preventive home visits on health care costs for ambulatory frail elders: a randomized controlled trial

“…Details on the procedures and selection of the study participants have been previously published [21, 22]. …”

“…The visits included structured multidimensional interview-based assessments of five key elements: locomotion, daily activities, social contacts or relationships with other people, health conditions, and signs of abuse [21]. Home visitors documented 40 potential health or psychosocial problems or difficulties and provided recommendations to each individual elder or caregiver [21]. All four visits were completed for the majority of participants (1st visit 87 %, 2nd visit 85.7 %, 3rd visit 83.9 %, and 4th visit 83.9 %).…”

“…All four visits were completed for the majority of participants (1st visit 87 %, 2nd visit 85.7 %, 3rd visit 83.9 %, and 4th visit 83.9 %). Further information can be found in our previous articles [21, 22]. We paid ¥5,000 JPY (approximately $50 USD) per person per year for the present preventive home visits from our research grant to municipal community-based comprehensive care centers.…”

“…Based on our multidimensional assessment model of preventive home visits [21], we previously reported a RCT that demonstrated that these home visits were effective for improving the functional status and depression among ambulatory frail elderly people with dependency in activities of daily living (ADLs) [22]. We hypothesized that the preventive home visit program may also be able to reduce health care costs, which is the subject of the present analysis [22].…”

Report from Sepulveda: A visit to the California Geriatric Evaluation Unit and Dr Rubenstein (the father of the Comprehensive Geriatric Assessment)

“…Now, in the VA Greater Los Angeles Healthcare Center in West Los Angeles, there is a 10‐bed Geriatric Evaluation and Management (GEM) Unit, which provides comprehensive and interdisciplinary geriatric assessments for patients with geriatric syndromes. Recently, Dr Rubenstein also has been taking advantage of the in‐home CGA and prevention 5 …”