Pilot project results from California were presented yesterday at the Alzheimer's Association International Conference in Boston. A six-month coordinated care study involving Alzheimer's patients and their caregivers based in San Francisco yielded impressive reductions in use of emergency department services along with other care improvements.
"Emergency room services were significantly reduced, almost cut in half," said Elizabeth Edgerly, chief program officer for Alzheimer's Association of Northern California. "It was at about 40%."
The reduction in emergency care indicates not only that patients are getting better care, but also that the project has the potential to save a lot of money, Edgerly said.
"That's a hard outcome to achieve. It looks like we may reduce costs at the same time. We help the patient do better, reduce crises and use of the ER. That's a win-win," Edgerly said. "We've shown many times you can improve quality, but [also reducing costs], it's hard to achieve that. That's why we're so excited about this project."
Edgerly was in Boston yesterday presenting the findings of the San Francisco study.
The Excellence in Dementia Care project is a joint effort of the Alzheimer's Association, Kaiser Permanente San Francisco, the city and county of San Francisco and UC-San Francisco, with some funding from the federal Administration on Aging, she said. The project hired a full-time dementia support nurse, established a 24-hour help line and consultation services and helped train existing caregivers in an effort to proactively head off crises and reduce emergency situations.
"We were looking at improving outcomes and effecting change in a relatively brief amount of time," Edgerly said. "What we were hoping for is that caregivers would feel like they're better caregivers, and the visits to the emergency room and hospital would decrease."
Hospital stays did not show the same kind of dramatic results as ED utilization reduction, but "it moved in the right direction," Edgerly said.
"We're already looking to expand this to other Kaiser sites," Edgerly said, "and hopefully to other medical facilities, as well."
Caregiver efficacy also showed strong improvement from the coordinated care effort, Edgerly said.
The San Francisco study was restricted to English speakers, she said, "and we are interested in offering it in communities other than English. We'd like to see if it holds true, and I expect it would, if we offer this in Chinese and Spanish."
Conference officials yesterday also released a national plan for addressing Alzheimer's and dementia care. California has a state plan in place. San Francisco is the only city in the nation to have its own strategic plan for handling dementia care, Edgerly said.