Cost-effectiveness of case management: a systematic review.

Abstract

In this time of aging and increasingly multimorbid populations, effective and efficient case management approaches play a crucial role in supporting patients who are navigating complex health care systems. Until now, no rigorous systematic review has synthesized studies about the cost-effectiveness of case management. A systematic review was performed. The bibliographic databases PubMed and CINAHL Plus were systematically searched using key blocks and synonyms of the terms case management, effectiveness, and costs. The methodological quality of the studies was assessed using the Consensus Health Economic Criteria list. A total of 29 studies were included. In 3 studies, the intervention was less effective and more costly than the control group and can therefore be considered not cost-effective. Two studies found that the intervention was less effective and less costly. A more effective and less costly intervention, and therefore a strong recommendation for case management, was found in 6 studies. In 17 studies, the intervention was more effective while being more costly. Nearly half of the studies met most of the quality criteria, with 16 or more points out of 19. Existing studies often have adequate quality and, in many cases, show cost-effective or even cost-saving results. Case management appears to be a promising method to support patients facing complex care situations. However, variation among case management approaches is very high, and the topic needs further study to determine the most cost-effective way of providing such care coordination.