Determining caseloads in the community care of frail older people with chronic illnesses

Abstract

The ageing population is a vulnerable group, and is entitled to live out their lives in the comfort and familiarity of their own homes where possible. Coordinated and supportive healthcare organizations and health system policies are critical to support empirically tested caseload indexes. These findings have implications for quality of care, planning and workforce policy development for our increasingly aged society. Recommendations for further research conclude this paper.

Nurse-led case management for community dwelling older people: an explorative study of models and costs

“…Large caseloads may jeopardize the effectiveness of case management (Yarmo Roberts 2002), but the extent to which lower caseloads, and increasing resources to patients, improves quality of care, reduces hospitalizations or other service use and affects nurse stress has not been fully established (Sargent et al. 2008, Williams & Cooper 2008). Larger studies that capture patient outcomes as well as costs are required to provide robust guidance to local service planners.…”

“…The findings of the present study suggest that monthly cost per patient managed by a community matron is relatively high, and not time limited, but more research is required on the cost-effectiveness of different models of case management (Singh 2006), and whether intensive input to selective patients is financially viable (Chapman et al 2009). Large caseloads may jeopardize the effectiveness of case management (Yarmo Roberts 2002), but the extent to which lower caseloads, and increasing resources to patients, improves quality of care, reduces hospitalizations or other service use and affects nurse stress has not been fully established (Sargent et al 2008, Williams & Cooper 2008. Larger studies that capture patient outcomes as well as costs are required to provide robust guidance to local service planners.…”

Measuring Home Care Caseloads

“…Staff participants made significant contributions to making the content of the tool comprehensive and clear in content. The inclusion of practice context issues, which acknowledges the team approach to care and the complexities of the system in which they are expected to apply the case management process, 30,31 was supported by staff input. The inclusion of interventions or direct hands on care was added to the tool when the steering committee and staff participants realized that the tool needs to capture all aspects of caseload intensity, not just the case management process.…”

Case Managed Community Aged Care

“…Case management approaches have been applied in community aged care in many countries. The major aims include coordinating fragmented care delivery systems, eliminating inappropriate service use and associated costs, substituting less costly communitybased care services for institutional care (including hospital care and nursing home care), and finally improving frail elderly people's health status, and overall well-being (Long, 2002;Watt, 2001;Williams & Cooper, 2008).…”