Abstract:Case Management is a term that is present in almost every American health care situation. It is mostly used to coordinate community services with satisfactory results for the patient within a certain period of time, with limited resources. Through time, it has been used for different purposes. The goal of this study was to show the historical evolution of case management as expressed by the American nursing literature, in the 80's and 90's, according to its use, meaning, and application, and following a theore… Show more
“…90 It reduces fragmentation and promotes continuity of care. 92,93 Until the 1990s, case managers were responsible for identifying eligible patients, assessing patient's needs, planning to meet those needs, linking patient to care provider(s), linking care providers, monitoring patient's care participation, detecting changing needs and advocating for patient's rights. 91,94,95 The latter is almost identical with McWhinney's 12 definition of continuity of care, while the linking of care providers resembles management/team/cross-boundary continuity.…”
The identified themes appear to be core elements of care to patients. Thus, it may be valuable to develop an instrument to measure these three common themes universally. In the patient-centred medical home, such an instrument might turn out to be an important quality measure, which will enable researchers and policy makers to compare care settings and practices and to evaluate new care interventions from the patient perspective.
“…90 It reduces fragmentation and promotes continuity of care. 92,93 Until the 1990s, case managers were responsible for identifying eligible patients, assessing patient's needs, planning to meet those needs, linking patient to care provider(s), linking care providers, monitoring patient's care participation, detecting changing needs and advocating for patient's rights. 91,94,95 The latter is almost identical with McWhinney's 12 definition of continuity of care, while the linking of care providers resembles management/team/cross-boundary continuity.…”
The identified themes appear to be core elements of care to patients. Thus, it may be valuable to develop an instrument to measure these three common themes universally. In the patient-centred medical home, such an instrument might turn out to be an important quality measure, which will enable researchers and policy makers to compare care settings and practices and to evaluate new care interventions from the patient perspective.
“…The concept of case management, in general, deals with the process of care both to patients and relatives, the complexity of problems, coordination between professionals, and the intervention. Certain disagreement is found regarding this last aspect on whether it is punctual or continuous in time, although, in general, it refers to continued care [9,10,11]. We understand that managing cases in nursing means assessing the care needs of a patient and his/her environment and coordinating the contribution of different health care providers.…”
The objective of the present study is to assess the model’s impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002–2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators’ tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p < 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients’ clinical condition as well as in the quality and efficiency of care.
“…Case management is a modality for the provision of health services aimed at complex chronic patients and primary caregivers who seek to respond to their needs and minimize the fragmentation of care. It is usually carried out by nursing staff along with an interdisciplinary team and is focused on high‐risk population groups and complex needs that generate high health costs (Casarin et al., ; Duarte, ; Morales‐Asencio, ). The Case Management Society of America describes it as: “a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality cost‐effective outcomes” (Case Management Society of America, , p. 11).…”
Section: Introductionmentioning
confidence: 99%
“…The Case Management Society of America describes it as: “a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality cost‐effective outcomes” (Case Management Society of America, , p. 11). In this regard, its main objectives aim at promoting comprehensive, coordinated and continuous care among different health and social service providers, improving the quality and effectiveness of interventions and reducing health costs (Casarin et al., ; Morales‐Asencio, ).…”
Aim: To determine the effectiveness of a case management model for approaching multi-pathological people in a health promoting entity of the contributory healthcare scheme in Bogotá, Colombia between 2018 -2019. Design: Mixed methods research. Method: The study contemplates two components: a quantitative component using a quasi-experimental analytical design before and after longitudinal intervention to determine the effectiveness of the case management model and a qualitative descriptive design to understand the experience of the participants about the model. The Administrative Department of Science, Technology and Innovation of Colombia (Colciencias) funded this project by means of call 777-November 2017, under the financing agreement No. 848-December 2017.Discussion: Addressing problems deriving from the structure of the Colombian healthcare system is crucial for implementing case management models. Furthermore, the effectiveness of such models may be affected by power relations and market failures, but the proved potential of a model may represent a generalized benefit for the Colombian health system.
Impact:In Colombia, considering complications and management of chronic noncommunicable diseases as isolated cases is considered as the highest cost events in healthcare provision, since an average of 12.8 million pesos is invested in each patient. This has led to rethink the management in these patients by means of a comprehensive model that guarantees the effectiveness of healthcare delivery, in the framework of a healthcare system heavily affected by payment capacity, where the market has a strong predominance, such as the case of Colombia.
Trial registration number: RPCEC00000293
K E Y W O R D Scase management, multiple chronic conditions, nursing, quality of health care
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