Table 1.
Characteristics of different models | Linkage model | Intensive case management/joint agency model |
---|---|---|
Central point for registration of cognitively impaired persons |
New clients are referred by GP or medical specialist to the central registration point after diagnosis |
New clients are referred by GP or medical specialist to the Multidisciplinary team at central registration point before or after diagnosis |
Possibility to diagnose dementia |
No, CM generally starts after diagnosis |
By Multidisciplinary team |
Starting point of case management |
After diagnosis |
Also possible before diagnosis; e.g. in case of MCI or suspicion of dementia. |
Delivery of services |
Independent and competitive organizations that often differ regarding case manager tasks and type of employment. |
Mainly by one organization that provides uniform case manager tasks |
Multidisciplinary team |
Intramural or extramural expert team that case managers can consult. Not always operating in the same organization. Frequency of consultation varies |
Elderly care physicians, neuropsychologist, neurologist, geriatrician, psychiatrist, dementia consultant all work within the same organization as case managers |
Financing | Annual contracts with insurance companies. Funding is provided based on the “Law on Exceptional Medical Expenses” (AWBZ) as well as municipalities (WMO). | Annual contracts with insurance companies. Funding is provided based on the Law on Exceptional Medical Expenses (AWBZ) as well as municipalities (WMO). Sometimes diagnostics and treatment tasks are funded by the Health Insurance Act (Zvw) and certain case manager tasks are covered by the Diagnostic Treatment Combinations (DBC). |
(CM = case management, GP = general practitioner, WMO = Social Support Act).
(*The COMPAS study investigates clinical, cost-effectiveness and process outcomes between the case management models and usual care).