A System for Spotting and Treating High-Risk Elderly Patients

Resource coordinators for chronic care patients in an independent physician association (IPA)

From 1995 to 1996, staff from the Legacy Good Samaritan Hospital and Medical Center in Portland, Ore., refined and evaluated the Community Resource Connection (CRC), an administrative system that used "resource specialists" to identify health care needs among elderly patients and link them to appropriate services.

The evaluation compared responses to mailed surveys from two patient groups: those enrolled in the program and those in a control group. Researchers also interviewed patients, health care providers, clinic staff and others.

In a related study, researchers from Legacy tested the reliability of a screening instrument called the Phu, which had been developed for the CRC, and compared it to the reliability of a previously validated screening instrument, called the Pra™.

The project was part of the Robert Wood Johnson Foundation (RWJF) Chronic Care Initiatives in HMOs program.

Key Findings

  • The evaluation findings indicated that:

    • The CRC had been received with enthusiasm by physicians and nursing staffs in the participating clinics, and by many patients; however, the project was not able to produce evidence of beneficial intervention effects over the 12-month trial period.
  • In the study of the screening instrument:

    • Researchers found the Phu to be as effective as, but not significantly better than, the Pra.

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