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Measuring quality in medical case management programs.

M G Henderson1, A Collard

  • 1Bigel Institute for Health Policy, Heller Graduate School, Brandeis University, Waltham, Massachusetts.

QRB. Quality Review Bulletin
|February 1, 1988
PubMed
Summary
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Medical case management programs aim to control costs for high-cost patients. Further development is needed to systematically measure program quality and patient outcomes.

Area of Science:

  • Health Policy
  • Healthcare Management

Background:

  • Private insurers and healthcare providers utilize medical case management programs.
  • These programs target patients with high-cost illnesses or injuries.
  • The primary goals are cost containment and quality enhancement.

Purpose of the Study:

  • To evaluate the effectiveness of medical case management programs.
  • To understand the reasons behind the popularity of these programs.

Main Methods:

  • A project evaluating medical case management programs was undertaken by Brandeis University's Bigel Institute for Health Policy since 1986.

Main Results:

  • Medical case management programs are popular due to the perception of inefficient handling of high-cost patients.

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  • There is a recognized need for systematic measurement and monitoring of case management quality and outcomes.

    • Conclusions:

    • Systematic approaches are required to assess the quality and impact of medical case management.
    • Further research and development are necessary to optimize these programs for patient care and cost-efficiency.