Impact of the Case Management Model through Community Liaison Nurses

Gonzalo Duarte-Climents,María Begoña Sánchez-Gómez,Cristobalina Rodríguez-Álvarez,Armando Aguirre-Jaime,José Ángel Rodríguez-Gómez,Antonio Sierra-López,Juan Gómez-Salgado

doi:10.3390/ijerph16111894

Abstract

The objective of the present study is to assess the model’s impact on patients and their families in terms of outcomes and the efficiency results for the health system in Tenerife, Canary Islands, selecting a period of eight years from the time interval 2002–2018. The employed indicators were collected on a monthly basis. They referred to home care and its impact on clinical outcomes and on the use of resources. The comparison between the indicators’ tendencies with and without the liaison nurse model was done with the F-test by Snedecor. All these tests are bilateral, with a level of significance of p < 0.05. In those areas with community liaison nurse (CLN), improvements have been found in indicators that describe: (1) the management of the clinical status of patients, (2) the efficiency of the use of resources, and (3) the quality and compliance with the process that also includes home visits and social risk detection and management. It can be said that in the basic areas of primary health care where the work of the CLN develops there are improvements in the management of the patients’ clinical condition as well as in the quality and efficiency of care.

Highlights

This figure shows the areas where the community liaison nurse (CLN) has been implemented during the study period and those that have been excluded from the analysis
Taking into consideration the limitations and biases that affect our study, we can affirm from its results that in the basic areas of primary health care where the work of the CLN develops improvements are obtained in the control of the clinical state of patients, in quality and efficiency of care
A strength of this study is that we identified the improvements achieved by the case management model and the CLN in the clinical state of patients, in the efficiency in the use of resources, and in the quality and compliance with the process

Summary

Introduction

The King’s Fund report of 2011 [1] makes use of the definition given by Hutt in 2004 as “the process of planning, coordinating, and reviewing the care of an individual” [2], and completes it with the definition of the Case Management Society of America: “a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost-effective outcomes” [3]. The first publication appearing in Medline on the case management topic dates back to the year and refers to the management of a patient with cerebral empyema [4]. Public Health 2019, 16, 1894; doi:10.3390/ijerph16111894 www.mdpi.com/journal/ijerph

Objectives

Methods

Results

Conclusion