A comparison of hospital and community case management programs for persons with AIDS

To determine whether locus of AIDS case management affects the content of this service, a survey of case managers in 42 major American cities was conducted. One hundred seventy-one case managers working in both public hospitals and community-based organizations (CBOs) responded. Hospital case managers were substantially more likely to report clinical training than CBO case managers. Hospital case managers' case loads were more likely to include drug users and patients with more urgent needs such as housing and drug abuse treatment. While CBO case managers were more likely to work to develop services in the community, hospital case managers reported working more closely with medical staff and discharge planning committees. CBO case managers reported greater difficulty obtaining a number of key services for their clients including home health care, housekeeping, and entitlements; hospital case managers reported greater difficulty obtaining emotional support volunteers. These results indicate that locus of case management strongly affects the structure and content of this service. The importance of these findings for future program planning is discussed.