Objectives: This study examined health care cost outcomes resulting from a health education program (HEP), a social work intervention for spouse caregivers of frail older adults. Method: One-hundred five spouses were recruited and randomly assigned to HEP or usual care (UC). Health care utilization and cost data were collected from the HMO's management information system for both the spouse caregivers and care recipients in quarterly increments for a 30-month period. Results: The results indicate that HEP was cost-effective. Caregivers and care recipients who participated in HEP had significantly lower overall health care costs and significantly lower outpatient costs than those who participated in usual care. Conclusions: By 2 years, total cost savings for caregivers and care recipients who participated in HEP was $309,461.14. HEP is a cost-effective intervention for caregivers and care recipients receiving medical care from a staff-model HMO.
Applegate, W., & Curb, J. (1990). Designing and executing randomized controlled trials involving elderly persons. Journal of the American Geriatrics Society, 38, 943-950.
2.
Bourgeois, M., Schulz, R.,& Burgio, L. (1996). Interventions for caregivers of patients with Alzheimer's disease: A review and analysis of content, process, and outcomes. International Journal of Aging–Human Behavior, 43(1), 35-92.
3.
Brodaty, H.,& Gresham, M. (1989). Effect of a training programme to reduce stress in carers of patients with dementia. British Medical Journal, 299, 1375-1379.
4.
Brodaty, H., Gresham, M.,& Luscombe, G. (1997). The Prince Henry Hospital dementia caregivers training programme. International Journal of Geriatric Psychiatry, 12, 183-192.
5.
Brodaty, H., McGilchrist, C., Harris, L., & Peters, K. (1993). Time until institutionalization and death in patients with dementia. Archives of Neurology, 50, 643-650.
6.
Brodaty, H., & Peters, K. (1991). Cost effectiveness of a training program for dementia caregivers. International Psychogeriatrics, 3, 11-22.
7.
Chu, P., Edwards, J., Levin R.,& Thompson, J. (2000). The use of clinical case management for early stage Alzheimer's patients and their families. American Journal of Alzheimer's Disease and Other Dementias, 15, 284-290.
8.
Drummond, M., Mohide, E., Tew, M., Streiner, D., Pringle, D., & Gilbert, J. (1991). Economic evaluation of a support program for caregivers of demented elderly. International Journal of Technology Assessment in Health Care, 7(2), 209-219.
9.
Engelhardt, J., Toseland, R., O'Donnell, J., Thomley, J., Jue, D., & Banks, S. (1996). The effectiveness and efficiency of outpatient geriatric evaluation and management. Journal of the American Geriatrics Society, 44(7), 847-856.
10.
Fillenbaum, G. (1978). Multidimensional Functional Assessment: The OARS methodology. Durham, NC: Duke University, Center for the Study of Aging and Human Development.
11.
Gibbons, R. D., Hedeker, D. R., & Elkin, I. (1993). Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Archives of General Psychiatry, 50, 739-750.
12.
Hedeker, D. (1995). Longitudinal data analysis. Cambridge, MA: Harvard University, JFK School of Government.
13.
Miller, L. L., Hornbrook, M. C., Archbold, P. G., & Stewart, B. J. (1996). Development of use and cost measures in a nursing intervention for family caregivers and frail elderly patients. Research in Nursing and Health, 19(4), 273-285.
14.
Mittleman, M., Ferris, S., Shulman, E., Steinberg, G., & Levin, B. (1996). A family intervention to delay nursing home placement of patients with Alzheimer's disease. Journal of the American Medical Association, 276, 1725-1731.
15.
Mohide, A. E., Pringle, D. M., Streiner, D. L., Gilbert, J. R., Muir, G., & Tew, M. (1990). A randomized trial of family caregiver support in the home management of dementia. Journal of the American Geriatrics Society, 38, 446-454.
16.
Montgomery, R.,& Borgotta, E. (1989). The effects of alternative support strategies on family caregiving. The Gerontologist, 29, 457-464.
17.
Peak, T., Toseland, R., & Banks, S. (1995). The impact of a spousecaregiver support group on care recipient health care costs. Journal of Aging and Health, 7, 427-449.
18.
Pfeiffer, E. (1975). A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23, 433-441.
19.
Riordan, J., & Bennett, A. (1998). An evaluation of augmented domiciliary service to older people with dementia and their carers. Aging and Mental Health, 2, 137-143.
20.
Robinson, B. (1983). Validation of a caregiver strain index. Journal of Gerontology, 38, 344-348.
21.
Schulz, R. (Ed.). (2000). Handbook on dementia caregiving: Evidenced-based interventions for family caregivers. New York: Springer.
22.
Toseland, R., & McCallion, P. (1998). Maintaining communication with persons with dementia. New York: Springer.
23.
Toseland, R., McCallion, P., & Smith, T. (in press). Supporting caregivers of frail older adults in an HMO setting. American Journal of Orthopsychiatry.
24.
Toseland, R., McCallion, P., Smith, T., Huck, S., Bourgeois, P., & Garstka, T. (2001). Health education group for caregivers in an HMO. Journal of Clinical Psychology, 57(4), 551-570.
25.
Toseland, R., O'Donnell, J., Engelhardt, J., Hendler, S., Thomley, J.,& Jue, D. (1996). Outpatient geriatric evaluation and management: Results of a randomized trial. Medical Care, 34(6), 624-640.
26.
Toseland, R., Smith, G., & McCallion, P. (1995). Supporting the family in elder care. In G. Smith, S. Tobin, E. Robertson-Tchabo, & P. Power (Eds.), Strengthening aging families: Diversity in practice and policy(pp. 3-24). Thousand Oaks, CA: Sage.
27.
Toseland, R., Smith, G.,& McCallion, P. (2001). Helping family caregivers. In A. Gitterman (Ed.), Handbook of social work practice with vulnerable and resilient populations(2nd ed., pp. 548-581). New York: Columbia University Press.
28.
Weinberger, M., Gold, D., Divine, G., Cowper, P., Hodgson, L., Schreiner, P., et al. (1993). Social service interventions for caregivers of patients with dementia: Impact on health care utilization and expenditures. Journal of the American Geriatrics Society, 41, 153-156.
29.
Zarit, S., Gaugler, J.,& Jarrott, S. (1999). Useful services for families: Research findings and directions. International Journal of Geriatric Psychiatry, 14, 165-181.
