Impact of person-centered and integrated care for community-living older adults on quality of care and service use and costs:Two sides of the same coin

Our healthcare system faces the challenges of coping with changing demands of a growing population of older adults while maintaining quality of care at lower costs. A crucial question, then, will be how to organize care and support to handle these challenges. Therefore, Embrace was developed: a person-centered and integrated-care service for community-living older adults. Research described in this thesis was performed in a number of rural communities in the north-east of The Netherlands . It aimed at evaluating effects of Embrace on quality of care and service use, as well as cost-effectiveness. Moreover, we examined change in the roles of healthcare professionals. The implementation of Embrace was successful. Case managers indicated that Embrace enables them to reduce the negative effects of fragmentation of care. Older adults judged their care as having improved. According to current accounting standards, Embrace was not yet cost-effective after 12 months, compared to usual care. Our research demonstrates that person-centered and integrated-care services such as Embrace may contribute to solving the challenges currently facing the Dutch healthcare system. It may be a growth model for improving population health and care as perceived by older adults