Why the study?
Does the PACT case-management program improve discharge rates and reduce length of stay in individuals newly admitted to nursing homes?
Does the PACT case-management program improve discharge rates and reduce length of stay in individuals newly admitted to nursing homes?
A nursing home transition case-management program (PACT) did not significantly improve discharge rates or reduce length of stay for newly admitted individuals compared to usual care.
Does not support PACT adoption for new nursing home admissions; challenges assumptions of benefit from case-management transition programs.
PURPOSE: The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a nursing home discharge plan. DESIGN AND METHOD: Reported are the results of a randomized control design evaluating the program's effectiveness. Those individuals randomly assigned to the intervention group (n = 33) received PACT case management in addition to their usual medical and nursing home care. The individuals in the control group (n = 29) continued their usual care. RESULT: There were no statistical differences in the discharge rate (84% treatment vs 76% controls) or in the median length of stay (42 days vs 55 days) between the two groups of individuals. IMPLICATIONS: Replications or extensions of a PACT-type intervention might consider a broader mix of nursing homes, working directly with the nursing home's admission Minimum Data Set coordinator in patient selection, or working with Medicare or Medicaid HMO plans.
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Newcomer et al. (2006) studied this question.
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