How do case managers spend time on their functions and activities?

Abstract

BackgroundCase management has been a widely accepted approach to practice in various care settings. This study aimed to explore how community aged care case managers allocated their time to case management functions, how frequently they performed specific case management activities, and what factors influenced the frequency of their activities.MethodsThe study involved 154 survey participants, or 17.1 % of the target case managers in the State of Victoria, Australia. Key information collected included participants’ socio-demographic characteristics, proportions of time allocated to six core case management functions, and frequency ratings of 41 specific activities within seven case management functions. Ordinal regression analyses were performed to determine significant factors associated with participants’ frequency ratings of their activities.ResultsParticipants allocated the largest proportion of time to care coordination (22.0 %), and the smallest proportion of time to outcome evaluation (8.0 %). Over 70 % of the participants assigned high frequency ratings to 31 of the 41 case management activities. The remaining ten activities, including all four outcome evaluation activities, three needs assessment activities, one care planning activity, one care coordination activity, and one general functions-related activity were less commonly performed very frequently. The regression analyses indicated that some case manager and client factors were significantly associated with frequency ratings of nine of the ten activities aforementioned. The two main findings of the regression analyses were: First, emphasising achieving more case management goals was significantly associated with higher frequency of three outcome evaluation activities; second, longer work experience was significantly associated with higher frequency of one care coordination activity and one outcome evaluation activity.ConclusionsThe frequent performance of most case management activities and relative absence of factors influencing their frequency suggest a uniformity of practice in community aged care case managers’ practice. What is not clear is whether the frequency of these activities (in particular less frequent performance of outcome evaluation activities) conforms to expectations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1333-6) contains supplementary material, which is available to authorized users.

Barriers to Effective Case Management for Disabled Patients on Hemodialysis

“…This study showed that care need levels did not significantly influence case management performance. Only a few client factors (such as having high care needs and having carers) were significantly associated with the frequency ratings of activities (7). Also, this study (7) showed that a lack of community resources and a lack of communication with surrounding people need not be related to performance at all steps (see (16) for the Japanese experience).…”

“…Only a few client factors (such as having high care needs and having carers) were significantly associated with the frequency ratings of activities (7). Also, this study (7) showed that a lack of community resources and a lack of communication with surrounding people need not be related to performance at all steps (see (16) for the Japanese experience). The reasons why patient factors, community resources or communication with stakeholders did not have a significant influence on CMs' performance may be related to their behavior when influenced by work overload.…”

“…Case management is a strongly promoted intervention in several developed counties. Although there are differences in case management systems due to different care settings and health systems across countries , it fundamentally consists of an assessment of an individual's needs, developing care plans based on this, accepting or arranging for mediation by home services as necessary, and monitoring/evaluating the care plan. As case management is the equivalent to ‘care management’ in Japan, this study uses the term “case management”.…”

“…Several researchers have examined the influences that case management can have on health, well‐being, and service use with respect to disabled people and their informal caregivers . In addition, there have been a few studies exploring the factors that affect case management performance . CMs who take charge of disabled patients on dialysis may have difficulties, because they have extra responsibilities in managing multiple medical and social needs, including patients' medical treatments, dietary requirements, clinic appointments, and psychosocial issues .…”

Care-managers’ professional choices: ethical dilemmas and conflicting expectations

“…Notably, accountability obligations may be more extensive than the degree of autonomy that professionals are permitted to exercise [ 32 ]. Furthermore, the care-managers make decisions that affect client outcome and overall system resources [ 33 ], while decision-making is influenced by the collective wisdom of the team, the role of family and the messiness of the process [ 34 ]. There is a tension and ambiguity that influences care-managers’ working conditions, thus contributing to increased stress levels and resultant staffing problems and affecting the quality of service given to older people in particular [ 35 ].…”