Case management effectiveness in reducing hospital use: a systematic review.

Area of Science:

• Healthcare Management
• Chronic Illness Care
• Systematic Review

Background:

• Chronic illnesses account for a significant portion of US healthcare costs (66%).
• Case management is proposed as a care coordination strategy to reduce healthcare expenditures.
• Previous research on its effectiveness in improving hospital use outcomes is contradictory.

Purpose of the Study:

• To systematically review recent evidence on the effectiveness of case management in reducing hospital use among individuals with chronic illnesses.
• To synthesize findings from randomized controlled trials focusing on hospital use as a primary outcome.

Main Methods:

• Systematic review adhering to Cochrane processes and PRISMA statements.
• Searched five electronic databases for randomized controlled trials.
• Included studies published within the last 10 years evaluating case management for chronic illness patients with hospital use as a primary outcome.

Main Results:

• Ten studies published between 2007 and 2015 were analyzed.
• Case management interventions, particularly transitional care services, were consistently associated with significant reductions in hospital readmissions.
• Emergency department visits were also substantially decreased by case management interventions.

Conclusions:

• Strong evidence supports case management's effectiveness in reducing hospital use for chronic illness patients.
• While reductions in hospital readmissions and ED visits are evident, overall effectiveness requires further investigation.
• More rigorously designed studies are needed to confirm the broader impact of case management interventions.