A cluster randomized controlled trial with repeated measures design will be conducted to test the effectiveness of six-month HCOACDM on the functional ability, QOL, depressive symptoms, healthcare and social service utilizations, and care delivery satisfaction of the high-need community older adults. The high-need community older adults, screened based on the High-need Community Older Adults Screening Scale (HCOASS), will be cluster randomized based on the community care centers, to the intervention group (4 centers) or comparison group (4 centers). Intervention group will receive six-month HCOACDM care and comparison group will receive original routine care provided by the care managers at community care centers. One pre-test and two post-tests, three months apart, of outcome measurements will be conducted on all participants. Moreover, individual semi-structured interviews will be carried out to explore opinions and suggestions toward the HCOACDM of the care managers in intervention group. It is expected that the developed HCOACDM will be useful to provide the long-term care for community older adults and enhance the quality of diverse and complex care delivery system.
This study is proposed to: (1) establish a High-need Community Older Adults Care Delivery Model (HCOACDM) as a guide to handle complex needs of the high-need community older adults by the care managers at community care centers; and (2) evaluate the effectiveness of applying the HCOACDM to improve the functional ability, quality of life (QOL), depressive symptoms, healthcare and social service utilizations, and care delivery satisfaction of the high-need community older adults.