Low-Income Geriatric Patients Fare Better With Integrated Care
According to a study released this week, low-income seniors fare much better when their health care involves an integrated approach that includes home-based and institutional services. The results of the two year study titled Geriatric Resources for Assessment and Care of Elders (GRACE), showed that community-dwelling low income patients who have integrated care experience improved quality of life and reduced utilization of acute care services. The study was conducted by Steven R. Counsell, M.D. of Indiana University and his colleagues and was reported in the December 12 issue of the Journal of the American Medical Association.
The GRACE intervention included in-home assessment and care management provided by a nurse practitioner and social worker team and extensive use of specific care protocols for common geriatric conditions. The study also used a Web-based care management tracking tool and integration with affiliated pharmacy, mental health, home health and inpatient geriatric care services.
The study found that the fee-for-service Medicare system does not reimburse costs for most of the services provided in the GRACE model. However, “Medicare managed care presents a financial vehicle under which the Grace intervention could be currently supported.”
The study pointed out that care should be personalized to meet each patient’s goals, values and resources and “physicians cannot do the job alone.” Team care, which has been a hallmark of geriatrics, is essential for providing high-quality care for patients of all ages who have chronic diseases. Further studies involving geriatric patients are currently being conducted.