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

Gage, Heather; Ting, Sharlene; Williams, Peter; Drennan, Vari; Goodman, Claire; Iliffe, Steve; Manthorpe, Jill; Davies, Sue; Masey, Helen

doi:10.1111/j.1365-2834.2012.01379.x

Cited by 48 publications

(10 citation statements)

References 32 publications

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“…According to Briggs [ 48 ], this is a common problem in economic evaluations where cost data are typically heavily skewed and therefore there are wide confidence intervals, meaning that very large differences or study samples are needed to achieve significant results. This wide range of costs has also been seen in other case management studies, for instance by Gage et al [ 8 ]. Our study included people with very low healthcare costs, and where prevention of costs is therefore unlikely.…”

Section: Discussionsupporting

confidence: 69%

“…This provides decision makers with valuable information to help them prioritise interventions and allocate money to different areas of healthcare, as well as to understand the cost consequences of healthcare interventions [ 7 ]. This makes economic evaluations of case management interventions important, and it has been suggested in a recent study that larger studies capturing patient outcomes as well as costs are required [ 8 ]. Studies have rarely evaluated costs in relation to utility outcomes that reflect the effects on the participants.…”

Section: Introductionmentioning

confidence: 99%

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Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial

et al. 2015

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BackgroundTo evaluate the effects of a case management intervention for frail older people (aged 65+ years) by cost and utility.Materials and methodsOne hundred and fifty-three frail older people living at home were randomly assigned to either an intervention (n = 80) or a control group (n = 73). The 1-year intervention was carried out by nurses and physiotherapists working as case managers, who undertook home visits at least once a month. Differences in costs and quality-adjusted life years (QALYs) based on the health-related quality-of-life instruments EQ-5D and EQ-VAS, and also the incremental cost-effectiveness ratio were investigated. All analyses used the intention-to-treat principle.ResultsThere were no significant differences between the intervention group and control group for total cost, EQ-5D-based QALY or EQ-VAS-based QALY for the 1-year study. Incremental cost-effectiveness ratio was not conducted because no significant differences were found for either EQ-5D- or EQ-VAS-based QALY, or costs. However, the intervention group had significantly lower levels of informal care and help with instrumental activities of daily living both as costs (€3,927 vs. €6,550, p = 0.037) and provided hours (200 vs. 333 hours per year, p = 0.037).ConclusionsThe intervention was cost neutral and does not seem to have affected health-related quality of life for the 1-year study, which may be because the follow-up period was too short. The intervention seems to have reduced hours and cost of informal care and help required with instrumental activities of daily living. This suggests that the intervention provides relief to informal caregivers.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial

et al. 2015

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“…The care process includes five essential steps: assessment, problem analysis, planning, implementation, and evaluation (Hudon et al, 2015 ; Klein & Evans-Agnew, 2019 ; Toney-Butler & Thayer, 2020 ). Following those steps, a nurse case manager should determine the formulation of a care plan to meet clients’ needs (Head et al, 2010 ; Brown et al, 2011 ; Manthorpe et al, 2012 ; Gage et al, 2013 ; Balard et al, 2016 ; Dhingra et al, 2016 ; Borgès Da Silva et al, 2018 ; Chapman et al, 2018 ; David et al, 2019 ; Cicutto et al, 2020 ). The care plan should be shifted from traditionally task-oriented to person-centered care (Uittenbroek et al, 2018 ) and involve family members to maintain the continuity of care.…”

Section: Resultsmentioning

confidence: 99%

“…Also, it revealed that most of the nursing case management models cater to specific targeted populations. For example, elderly (Manthorpe et al, 2012 ; Gage et al, 2013 ; Balard et al, 2016 ; You et al, 2016 ), patients with long-term illness (Hudon et al, 2015 ; Uittenbroek et al, 2018 ), palliative patients (Head et al, 2010 ; Dhingra et al, 2016 ), students/children (Setiawan et al, 2016 ; Setiawan & Dawson, 2018 ; Klein & Evans-Agnew, 2019 ; Cicutto et al, 2020 ) and people living with mental health problems (Chapman et al, 2018 ) are the populations reported as the beneficiaries in this study. In one study conducted in Norway, Tønnessen et al ( 2017 ) displayed nurse case managers as health providers to serve diverse populations with varied health conditions.…”

Section: Discussionmentioning

confidence: 99%

Implementation of nursing case management to improve community access to care: A scoping review

Putra

Sandhi

2021

Belitung Nurs J

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Background: Case management is an approach used to help patients locate and manage health resources as well as to enhance effective communication among patients, families, and health systems. Nurses’ role as case managers has been proven effective in reducing healthcare costs among patients with chronic diseases. However, little is known about its implementation in improving access to care in community-based settings. Objectives: This scoping review aimed to examine the components of nursing case management in improving access to care within community settings and to identify the issues of community-based nursing case management for future implications. Design: This study was conducted following the framework of scoping review.Data Sources: The authors systematically searched five electronic databases (CINAHL, PubMed, Science Direct, Scopus, and Google Scholar) for relevant studies published from January 2010 to February 2021. Only original studies involving nurses as one of the professions performing case management roles in the community-based settings, providing 'access to care' as the findings, were included. Review Methods: The article screening was guided by a PRISMA flowchart. Extraction was performed on Google Sheet, and synthesis was conducted from the extraction result.Results: A total of 19 studies were included. Five components of nursing case management to improve access to care were identified: 1) Bridging health systems into the community, 2) Providing the process of care, 3) Delivering individually-tailored health promotion and prevention, 4) Providing assistance in decision making, and 5) Providing holistic support. In addition, three issues of nursing case management were also identified: 1) Regulation ambiguity, 2) High caseloads, and 3) Lack of continuing case management training.Conclusion: Care coordination and care planning were the most frequent components of nursing case management associated with access to care. These findings are substantial to improve nurses' ability in performing the nursing process as well as to intensify nurses’ advocacy competence for future implications.

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“…The challenge is in whether these skills and attributes are translated in practice because few research studies identify DN participants as specialist practitioners in their findings. A number of studies describe the role as practical although SPDNs in the studies claimed their expertise was in case management and equal to identified case managers (O'Brien & Jack, ; King, Melvin, Ashby, & Firth, ; Gage et al., ). Chan et al.…”

Section: Introductionmentioning

confidence: 99%

Expertise in action: Insights into the dynamic nature of expertise in community‐based nursing

Dickson

McVittie

Kapilashrami

2018

Journal of Clinical Nursing

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

Abstract: The case for continued investment in community matrons remains to be proven.

Cited by 48 publications

References 32 publications

Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial

Cost-utility analysis of case management for frail older people: effects of a randomised controlled trial

Implementation of nursing case management to improve community access to care: A scoping review

Expertise in action: Insights into the dynamic nature of expertise in community‐based nursing

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