Flexible client-driven in-home case management: an option to consider

Area of Science:

• Health Services Research
• Gerontology
• Public Health Policy

Background:

• Increasing demand for in-home case management due to evolving health services and care needs.
• Previous evaluations indicate a need for adaptable case management approaches to optimize cost-effectiveness.
• Varied client circumstances necessitate tailored interventions at different times.

Purpose of the Study:

• To evaluate a flexible, client-driven case management model in a Canadian home care program.
• To identify implementation challenges, policy impediments, and client/provider outcomes associated with offering choices in case management models.
• To understand client, provider, and caregiver outcomes of flexible, client-driven care.

Main Methods:

• Employed an exploratory, multi-measure, quasi-experimental design.
• Utilized a generic program evaluation model incorporating both quantitative and qualitative methodologies.
• Examined client characteristics within integrated team, consumer-managed, and brokerage case management models.

Main Results:

• Alternative case management models attract distinct client populations.
• Offering a choice of case management models did not significantly alter care costs or client outcomes.
• Flexible client-driven case management was positively perceived by case managers and other healthcare providers.

Conclusions:

• Flexible client-driven case management successfully engages clients as partners in selecting their preferred service model.
• The choice of case management model, while attracting different client groups, does not impact overall costs or outcomes.
• Further longitudinal research is recommended, but findings suggest positive experiences for providers and potential benefits for care management strategies.