In a systematic review, researchers identified three characteristics of case management programs that consistently yielded positive results: case selection for frequent users with complex problems, high-intensity case management interventions and a multidisciplinary care plan. This review included data from 20 studies, 17 of which were quantitative, of adult frequent users with chronic diseases in primary, secondary and tertiary care settings. Case management was delivered in a primary care setting in all of the studies. Factors such as health care system use, financial cost and patient outcomes were the primary outcomes assessed. All the case management interventions with positive outcomes included some method of identifying patients most likely to benefit. Most of the methods with positive outcomes included high-intensity case management interventions and care plans developed by multidisciplinary teams. The author suggests that policymakers and clinicians should focus on finding an appropriate method to identify patients most likely to benefit from case management. A high-intensity case management intervention and/or access to a multidisciplinary team may also improve outcomes.
Characteristics of Case Management in Primary Care Associated With Positive Outcomes for Frequent Users of Health Care: A Systematic Review
Catherine Hudon, MD, PhD, CFPC et al
Université de Sherbrooke, Department of Family Medicine and Emergency Medicine, Quebec, Canada