In search of a nursing case management model for rural hospitals

Research has provided increasing evidence that nursing case management is a cost-effective way to maximize health outcomes for high-risk, high-cost, high-volume patients (Ely, Walker, & Berger, 1993: Etheridge & Lamb, 1989; Krieger, Connell, & LoGerfo, 1992; Green, Lovely, Miller, & Ondrich, 1989; Schull, Tosch, & Wood, 1992; Zander, 1988). However, models of nursing case management developed in urban settings and tested primarily on urban populations do not address the needs of rural people and areas. This article proposes a definition of nursing case management for rural hospitals that is grounded in the reality of rural practice and offers a meaningful approach to the provision of care to underserved populations, cost containment, and recruitment and retention of registered nurses.