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Case management programs in primary care

J A Ferguson1, M Weinberger

  • 1Center for Health Services Research, Roudebush Veterans Affairs Medical Center, Indiana University School of Medicine, Indianapolis 46202, USA.

Journal of General Internal Medicine
|March 21, 1998
PubMed
Summary
This summary is machine-generated.

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Case management programs show mixed results in healthcare. While patient-centered outcomes often improve, impacts on resource use and cost-effectiveness are inconsistent, particularly for general conditions.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Clinical Outcomes

Background:

  • Case management programs aim to improve patient outcomes and manage healthcare resource utilization.
  • The effectiveness of these programs across various patient populations and healthcare settings requires thorough evaluation.

Purpose of the Study:

  • To review the impact of case management on health care resource use.
  • To assess the effect on patient satisfaction, quality of life, and functional status (patient-centered outcomes).
  • To evaluate the cost-effectiveness of case management programs.

Main Methods:

  • Systematic literature review of randomized controlled trials.
  • Searched MEDLINE and HealthSTAR databases using specific keywords.
  • Manual data extraction and descriptive presentation of findings.

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Main Results:

  • Only two of seven studies showed reduced health resource use, linked to specific disease conditions and specialist supervision.
  • All six studies on patient-centered outcomes reported positive impacts, irrespective of patient condition or study personnel.
  • Clinical parameters improved in both studies examining them; cost savings were not significant in the three studies that assessed costs.

Conclusions:

  • Case management offers theoretical benefits, but successful implementation is not widespread.
  • Program success is associated with specific disease conditions and specialized personnel.
  • Improvements in patient-centered outcomes are noted, but cost-effectiveness remains unclear, necessitating further research.