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Related Concept Videos

Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Continuing Care01:25

Continuing Care

Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
Documentation in Long-Term and Home Healthcare Setting01:29

Documentation in Long-Term and Home Healthcare Setting

Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Chronic Obstructive Pulmonary Disease-V: Nursing Management01:30

Chronic Obstructive Pulmonary Disease-V: Nursing Management

Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Planning Nursing Care I01:21

Planning Nursing Care I

The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...

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Related Experiment Videos

A comprehensive case management program to improve palliative care.

Claire M Spettell1, Wayne S Rawlins, Randall Krakauer

  • 1Aetna Informatics, Aetna, Blue Bell, Pennsylvania 19422, USA. SpettellCM@aetna.com

Journal of Palliative Medicine
|September 2, 2009
PubMed
Summary
This summary is machine-generated.

Comprehensive case management (CM) and expanded hospice benefits significantly increased hospice use and days, while reducing inpatient stays for health plan members. This suggests benefits can be liberalized within CM programs without increasing costs.

Related Experiment Videos

Area of Science:

  • Health Services Research
  • Palliative Care
  • Health Insurance

Background:

  • Access to hospice care is crucial for end-of-life care, but utilization remains suboptimal.
  • Barriers to hospice care include complex insurance benefits and lack of coordinated support.
  • Case management (CM) and benefit design are potential levers to improve hospice access.

Purpose of the Study:

  • To assess the effect of comprehensive case management (CM) and expanded insurance benefits on hospice and acute care utilization.
  • To determine if these interventions impact the proportion of patients using hospice, duration of hospice care, and acute inpatient stays.

Main Methods:

  • Retrospective cohort study design comparing intervention groups with historical controls.
  • Intervention groups included commercial and Medicare enrollees receiving CM, with some commercial enrollees also receiving expanded hospice benefits.
  • Outcomes measured via medical claims data included hospice utilization, hospice days, and inpatient days.

Main Results:

  • Hospice use dramatically increased in all CM groups compared to controls (e.g., commercial CM: 30.8% to 71.7%).
  • Mean hospice days significantly increased across intervention groups (e.g., commercial CM: 15.9 to 28.6 days).
  • Inpatient acute care utilization decreased for all groups receiving CM services.

Conclusions:

  • Comprehensive case management, coupled with liberalized hospice benefits, can effectively overcome barriers to hospice utilization.
  • Expanding hospice benefits within CM programs appears feasible without negatively impacting overall healthcare costs.
  • These findings support integrating CM with benefit enhancements to improve end-of-life care delivery.