The triage experiment in coordinated care for the elderly

Abstract

Triage is a model project designed to overcome the organizational and financial barriers inhibiting the provision of appropriate care to the elderly. Teams made up of a nurse clinician and a social worker performed assessment, service coordination, and monitoring functions. Services arranged by the teams were financed through a series of waivers on the use of the Medicare Trust Fund. Three hundred and seven Triage clients were followed and compared to a group of 195 elderly in a two year quasi-experimental study of functioning status outcomes, use of services, and health care costs. Triage clients had slightly better mental functioning outcomes than comparison clients; results of physical and social functioning outcomes were inconclusive. Both service utilization and costs were somewhat higher for Triage clients; the proportional difference in utilization was greater than the proportional difference in costs.