Community based nurse case managers: a model to meet New Zealand's changing health care needs

Policy-makers are concerned to find ways to improve the quality, accessibility and continuity of care, contain costs and ultimately to reduce the rate of institutionalisation. The health reform in New Zealand proposes to open up the way for nurses to be more extensively and effectively involved in primary and community based care in order to meet these needs. The role of nurses as community based nurse case managers in the United States is reviewed and demonstrates very clearly not only is the quality of health care enhanced but also the client and fiscal outcomes improved. The challenge from the reform is for nurses to see the opportunities and to take the initiative before it is taken by other disciplines.