Approaches to case management in Puerto Rican communities

This article reviews some critical elements of case management as they apply to Puerto Ricans seeking quality and consistency in health care and social services in a system which is culturally foreign, difficult to negotiate, and frequently unresponsive, especially to those with limited economic resources and government rather than private insurance. Following a brief outline of some principles of case management, we discuss aspects of Puerto Rican history, family organization, and health-seeking behavior that relate to case management. Descriptions of three programs illustrate several case management approaches that combine methods to access care with those needed to organize coordinated inter-institutional care. Finally, we suggest ways for case managers to successfully work with Puerto Rican families.