Key factors of case management interventions for frequent users of healthcare services: a thematic analysis review

Abstract

ObjectiveThe aim of this paper was to identify the key factors of case management (CM) interventions among frequent users of healthcare services found in empirical studies of effectiveness.DesignThematic analysis review of CM studies.MethodsWe built on a previously published review that aimed to report the effectiveness of CM interventions for frequent users of healthcare services, using the Medline, Scopus and CINAHL databases covering the January 2004–December 2015 period, then updated to July 2017, with the keywords ‘CM’ and ‘frequent use’. We extracted factors of successful (n=7) and unsuccessful (n=6) CM interventions and conducted a mixed thematic analysis to synthesise findings. Chaudoir’s implementation of health innovations framework was used to organise results into four broad levels of factors: (1) environmental/organisational level, (2) practitioner level, (3) patient level and (4) programme level.ResultsAccess to, and close partnerships with, healthcare providers and community services resources were key factors of successful CM interventions that should target patients with the greatest needs and promote frequent contacts with the healthcare team. The selection and training of the case manager was also an important factor to foster patient engagement in CM. Coordination of care, self-management support and assistance with care navigation were key CM activities. The main issues reported by unsuccessful CM interventions were problems with case finding or lack of care integration.ConclusionsCM interventions for frequent users of healthcare services should ensure adequate case finding processes, rigorous selection and training of the case manager, sufficient intensity of the intervention, as well as good care integration among all partners. Other studies could further evaluate the influence of contextual factors on intervention impacts.

Challenges of adopting the role of care manager when implementing the collaborative care model for people with common mental illnesses: A scoping review

“…For all these reasons, recruiting a competent CM can be challenging, as is the case in other types of interventions oriented towards the care management of a complex clientele (Hudon et al . ).…”

Characteristics of Case Management in Primary Care Associated With Positive Outcomes for Frequent Users of Health Care: A Systematic Review

“…Previous research, 60,[62][63][64] as well our prior thematic analysis review on key factors of CM interventions, 65 have recognized the importance of appropriate patient identification. Previous studies, however, have defined the appropriateness of patient identification on the basis of patients' risk of frequent health care use and associated cost to health care systems.…”

Decisional needs assessment of patients with complex care needs in primary care

“…Thorne and colleagues investigated everyday self-care decision making among persons with chronic illness, but who are not specifically frequent users 23. Numerous studies have shown that patient engagement in case management programs fosters successful interventions and can greatly improve patients' health status 11,[24][25][26]. On the other hand, this remains hard for a lot of patients since half of the patients involved in our study identified the decision "Do I acknowledge my condition and accept to be involved in its management?"…”