Case Management Model Research Articles

Reducing frequent visits to Emergency Departments

BACKGROUND: The Health and Wellbeing Connection (HWC) pilot study was undertaken by Richmond Services in partnership with Pegasus Health, Partnership Health and the Canterbury District Health Board.OBJECTIVE: To explore whether a brief intervention offered to frequent attenders to hospital emergency department (ED) was successful in reducing inappropriate attendance.METHODS: Administration of the Kessler Depression and Anxiety (K10) scale; the World Health Organization Quality of Life Measure (WHOQOL-BREF); extracted de-identified rates of attendance at an ED of a general hospital and general practice, and follow up telephone interviews with study participants were used.RESULTS: By the end of the project, a total of 53 participants had completed the programme. On average, these participants reduced their attendance at the ED significantly while demonstrating no change in their attendance rates at general practice. Additionally, they reported a decrease in psychological distress and a positive increase in their quality of life.CONCLUSION: Although the number of participants in this study does not allow for robust analysis of efficacy of the program offered, it does indicate that there is merit in continuing to develop brief intervention case management models to support behaviour change programmes in hospital EDs.

Ambient Assisted Living - design recommendations for a case management and a respective business model

Ambient Assisted Living - design recommendations for a case management and a respective business model

An Integrated Case Management Model to Assist Pacific Youth Offenders and Their Families in Australia.

Pasifika Support Services (PSS) was a program managed by a nongovernment organization, Mission Australia, and funded by the New South Wales Premiers Office to meet the needs of young offenders from a Pacific background. PSS ran from June 2005 to June 2009 and implemented a cost-effective integrated case management model with the New South Wales Police Force adapted to address social risk factors specific to Pacific youth offenders and family support networks. Sixty young people were reviewed regarding the outcomes achieved through their participation, further supported by an evaluation carried out by an external evaluator who found that 65% of participants did not reoffend after 18 months of completing the program. An importance of developing a shared approach to employing a holistic and intensive model of case management that affects individual, community, and organizational change through culturally relevant processes and practices, paired with a cross institutional commitment underpins the various outcomes discussed.

Effects of case management model on the quality of life for patients with lung cancer

Objective To explore the application and effect of case management model in patients with lung cancer. Methods Totally 88 patients with lung cancer were divided into the experimental group and the control group according the wards. The patients in the experimental group received a six-month case management program, while the patients in the control group received routine nursing and follow-up. The quality of life of patients was evaluated at the first day of admission after diagnosis, one month, three months and six months after the treatment. The changes of several indexes in half a year during the study were analyzed by repeated-measure analysis of variance and multiple factor analysis of variance. Results In the experimental group, the scores of the patients in physical functioning, role functioning and global health status were higher than that in the control group after six-month′s nursing care (F=19.449, 13.291, 4.929; P<0.05); the scores of patients in the experimental group in appetite loss, fatigue, dyspnea and pain were lower than that in the control group (F=5.032, 5.152, 4.287, 10.734; P<0.05). Conclusions The case management model can improve the quality of life of lung cancer patients, and it should be applied to the lung cancer patients with condition. Key words: Lung cancer; Case management model; Quality of life

Application of Omaha system-based case management model in ICU patients with severe respiratory failure

Objective To explore the effects of Omaha system-based case management model on the prognosis of ICU patients with severe respiratory failure. Methods Totally 84 cases of patients with severe respiratory failure in our hospital from June 2014 to June 2016 were selected and divided into the observation group (n=42) and the control group (n=42) according to random number table. Patients in the control group were given routine nursing during ventilation, while patients in the observation group were given Omaha system-based case management model. The prognosis and complications of patients in two groups were compared. Results The level of blood lactate, the scores of acute physiology and chronic health evaluation system (APACHEⅡ), and the rates of ventilator-dependent, ventilator associated pneumonia (VAP) and reintubation were all lower than the data in the control group, while the time of mechanical ventilation and staying in ICU, as well as the total hospitalization time were all shorter than the time in the control group (P<0.05). Conclusions The Omaha system-based case management model can effectively improve the prognosis of ICU mechanically ventilated patients with severe respiratory failure, shorter the hospitalization time, and improve patient satisfaction. Key words: Respiration, artificial; Prognosis; Severe respiratory failure; Omaha system; Case management model

A commentary on case management model for chronic diseases in China

This commentary begins with standards and the key elements of case management in western countries, and summarized the current situation and problems of case management in China. Foreign countries have established the standards of practice for case management, which included the national self assessment for case management practice, the national code of ethics for case management, and the national skill set for effective case management. The authors believe that the cooperation of multiple disciplines and institutions is the key element, the needs of patients are the orientation, and case managers are the central coordinator. The main problems of case management in our country includes the misunderstanding of concepts of case management, limited resource and information, lack of training and assessments of case managers, and lack of quality control and outcome evaluation system. Key words: Chronic diseases; Case management model; Commentary

Implementation and (cost-)effectiveness of case management for people with dementia and their informal caregivers: results of the COMPAS study

Different forms of case management for dementia have emerged over the past few years. In the COMPAS study (Collaborative dementia care for patients and caregivers study), two prominent Dutch case management forms were studied: the linkage and the integrated care form. Evaluation of the (cost)effectiveness of two dementia case management forms compared to usual care as well as factors that facilitated or impeded their implementation. A mixed methods design with a) a prospective, observational controlled cohort study with 2 years follow-up among 521 dyads of people with dementia and their primary informal caregiver with and without case management; b) interviews with 22 stakeholders on facilitating and impeding factors of the implementation and continuity of the two case management models. Outcome measures were severity and frequency of behavioural problems (NPI) for the person with dementia and mental health complaints (GHQ-12) for the informal caregiver, total met and unmet care needs (CANE) and quality adjusted life years (QALYs). Outcomes showed a better quality of life of informal caregivers in the integrated model compared to the linkage model. Caregivers in the control group reported more care needs than those in both case management groups. The independence of the case management provider in the integrated model facilitated the implementation, while the rivalry between multiple providers in the linkage model impeded the implementation. The costs of care were lower in the linkage model (minus 22 %) and integrated care model (minus 33 %) compared to the control group. The integrated care form was (very) cost-effective in comparison with the linkage form or no case management. The integrated care form is easy to implement.

House broken: homelessness, housing first, and neoliberal poverty governance

ABSTRACTHousing First (HF) is the new orthodoxy when dealing with the small, long-term, visible and recalcitrant fraction of the greater homeless population. Unlike more traditional, “treatment first” models that expect “self-sufficiency” before clients should achieve housing, this markedly cost-effective program/policy rapidly places homeless people who “consume” the most state resources into their own subsidized apartment. Many conclude that such an upending renders HF an exceptionally progressive program that ousts the disciplinary, paternalist traditions of poverty governance. Using evidence from two programs in metropolitan Phoenix, AZ, however, I argue that housing indeed comes first, but paternalism is right there behind it. Further, I argue that the program’s apartment lease – in what remains commodified housing – is no benign social relationship. It is, rather, a lever of market discipline. In HF, the abstract compulsions of the market significantly but incompletely replace the older, more paternalistic and personal models of disciplinary case management. As such, HF exemplifies a form of neoliberal poverty governance despite its relatively “progressive” platform.

Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

BackgroundIn 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006–2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users’ (old people and their informal caregivers) and case managers’ first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation.MethodsThe study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out.ResultsThe analysis revealed that each group of people generated its own representations of the case manager’s role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager.ConclusionThe innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual’s projected expectations of this social service.Analyzing the first representations of the case manager’s role during the implementation phase of the CM service appears as a necessary step before considering the effects of the services. The implementation and the success of a case management model have to be evaluated regarding the previous healthcare context and the expectations of the people involved.

Developing a New Approach to Case Management in Youth Mental Health: Strengths Model for Youth Case Management

Strengths Model (SM) case management has been utilized as a community based intervention with adults diagnosed with a mental illness since the 1980s. This paper describes the developmental, familial, and systemic adaptations made to the model so that it can be used with youth with mental illness. The resulting SM for Youth provides an alternative framework for providing case management to youth with mental illness which allows the youth to drive goal development and attainment by identifying and capitalizing on the youth’s strengths and resources. The model has the potential to positively impact youth mental health services by equipping supervisors and case managers with a formal model and tools, helping the case managers to feel more prepared and less stressed in their roles, and by empowering youth to engage in services that are positive and driven by their desires.

Effects of personal follow-up guidance based on case management on functional outcome and treatment compliance of elderly stroke patients

Objective To explore the effects of personal follow-up guidance based on case management on functional outcome and treatment compliance of elderly stroke patients, and lay the foundation of stroke case management (CM) work. Methods Totally 169 elderly stroke patients were randomly divided into the the experimental group(n=83)and the control group (n=86). Patients in the control group were given routine follow-up guidance, while patients in the experimental group were given the personal follow-up guidance based on case management. The activities of daily living and functional outcome of patients in two groups were evaluated by modified Barthel index (MBI) and modified Rankin scale(MRS) at the time of joining the group, 1 month, 3 months, and 6 months after discharge. The compliance was evaluated by self-designed compliance questionnaire. Results There was no significant difference in MBI and MRS score between the experimental and the control group when joining the study and 1 month after discharge(P>0.05). The MBI score of the experimental group was significantly higher and the MRS score of the experimental group was significantly lower than that in the control group at 3 months and 6 months after discharge (P 0.05), and was significantly different besides balanced diet at 3 months after discharge (P 0.05). Conclusions The personal follow-up guidance based on the case management model can improve the activities, functional outcome and compliance of elderly stroke patients. Key words: Stroke; Elderly; Rehabilitation; Case management; Personal follow-up guidance; Compliance

Recovery coaches and the stability of reunification for substance abusing families in child welfare

Substance abuse is a long-standing challenge for child welfare systems. Parental substance abuse disrupts family stability, family cohesion, and jeopardizes the well-being of children. In the current study we test an intervention to improve child welfare outcomes for substance abusing families, specifically the probability of families achieving a stable (at least 12months) reunification. The intervention was an integrated case management model where recovery coaches were appointed to substance abusing parents associated with an open foster care placement. A diverse group of families (n=1623) were randomly assigned to either a control group (services as usual) or an experimental group (services as usual plus a recovery coach). Multinomial logistic regression indicated that substance abusing parents associated with a recovery coach were significantly more likely to achieve a stable reunification as compared with similar families in the control group.

Online Versus Face-to-Face Training of Critical Time Intervention: A Matching Cluster Randomized Trial

ABSTRACTThis study examined the effectiveness of online education to providers who serve people experiencing homelessness, comparing online and face-to-face training of Critical Time Intervention (CTI), an evidence-based case management model. The authors recruited 184 staff from nineteen homeless service agencies to participate in one of two training conditions: (a) Online Training + Community of Practice or (b) Face-to-Face Training + Telephone Consultation. Each group received twenty-four hours of instruction and support. Through baseline, follow-up, and nine-month posttraining surveys, the authors examined satisfaction, knowledge gains, knowledge retention, and readiness to implement CTI. Although satisfaction rates were higher among participants in the face-to-face group, the two training conditions produced comparable pre/postknowledge gains. Furthermore, both groups showed increased knowledge retention scores at nine-month follow-up, with the online group scoring higher than the face-to-face group.

Responding to the Increased Needs of College Students: A Case Study of Case Management

ABSTRACTThe psychological needs of college students lead to overwhelming demand on college counseling centers’ resources. In this article, we review models of case management in Higher Education including the administrative, behavioral intervention, and counseling center models. We also present a case study of the 3-year development of a counseling center case management service. Initial data suggest that expanding the role of a counseling center case manager to allow for frequent appointments/follow-up and standardizing counseling center case management procedures led to improved appointment attendance and increased communication with students following referral. A vignette and suggestions for other centers are also presented.

The case management with colostomy: a review

This paper introduced the definition of case management, the application of case management model in China and abroad, analyzed the necessity of the implementation of colostomy case management in the field of patients with colostomy, and then discussed the challenges and solving strategies in the delivery of colostomy case management in China in order to provide a theoretical basis for the establishment and promotion of colostomy case management model. Key words: Colostomy; Case management; Review

The Cost-Effectiveness of Two Forms of Case Management Compared to a Control Group for Persons with Dementia and Their Informal Caregivers from a Societal Perspective.

ObjectivesThe objective of this article was to compare the costs and cost-effectiveness of the two most prominent types of case management in the Netherlands (intensive case management and linkage models) against no access to case management (control group) for people with already diagnosed dementia and their informal caregivers.MethodsThe economic evaluation was conducted from a societal perspective embedded within a two year prospective, observational, controlled, cohort study with 521 informal caregivers and community-dwelling persons with dementia. Case management provided within one care organization (intensive case management model, ICMM), case management where care was provided by different care organizations within one region (Linkage model, LM), and a group with no access to case management (control) were compared. The economic evaluation related incremental costs to incremental effects regarding neuropsychiatric symptoms (NPI), psychological health of the informal caregiver (GHQ-12), and quality adjusted life years (QALY) of the person with dementia and informal caregiver.ResultsInverse-propensity-score-weighted models showed no significant differences in clinical or total cost outcomes between the three groups. Informal care costs were significantly lower in the ICMM group compared to both other groups. Day center costs were significantly lower in the ICMM group compared to the control group. For all outcomes, the probability that the ICMM was cost-effective in comparison with LM and the control group was larger than 0.97 at a threshold ratio of 0 €/incremental unit of effect.ConclusionThis study provides preliminary evidence that the ICMM is cost-effective compared to the control group and the LM. However, the findings should be interpreted with caution since this study was not a randomized controlled trial.

Letter to the Editor: The Emerging Role of Pharmacists in the Multidisciplinary Care of Patients with Multiple Sclerosis.

Letter to the Editor: The Emerging Role of Pharmacists in the Multidisciplinary Care of Patients with Multiple Sclerosis.

Effects of a Health and Social Collaborative Case Management Model on Health Outcomes of Family Caregivers of Frail Older Adults: Preliminary Data from a Pilot Randomized Controlled Trial.

Family caregiving is an important form of informal care provided to frail, community-dwelling older adults. This article describes a health and social collaborative case management (HSC-CM) model that aims to optimize the support given to caregivers of frail elderly adults. The model was characterized by a comprehensive assessment to identify the caregiver's needs; a case management approach to provide integrated, coordinated, continued care; and multidisciplinary group-based education customized to the caregiver's individualized needs. A pilot study using a randomized controlled trial study design was conducted to evaluate the effects of the HSC-CM on caregiver burden and health-related quality of life of family caregivers of frail elderly adults. Sixty family caregivers (mean age 61.3 ± 15.5) of frail older adults recruited from a community center for elderly adults in Hong Kong were randomly assigned to receive a 16-week HSC-CM intervention or usual care. Case managers who conducted a comprehensive assessment of the care dyads to identify caregiver needs using a case management approach to optimize care coordination and continuity led the HSC-CM. These case managers served as liaisons for multidisciplinary efforts to provide group-based education according to caregiver needs. Family caregivers who participated in the HSC-CM had significantly greater improvement on the Caregiver Burden Index (p = .03) and on the Medical Outcomes Study 36-item Short-Form Survey subscales, including vitality (p = .049), social role functioning (p = .047), and general well-being (p = .049). This study provides preliminary evidence indicating that client-centered care, a case management approach, and multidisciplinary support are crucial to an effective caregiving support initiative. A full-scale study is required to validate these findings.

Aboriginal and Torres Strait Islander Case Management Model Improves GP 7-Day Follow-up Rates

Aboriginal and Torres Strait Islander Case Management Model Improves GP 7-Day Follow-up Rates

Influences on Case-Managed Community Aged Care Practice.

Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts.