Making a Case for Case Management

Physician Groups Are Beginning to Implement Programs Once Confined to HMOs and Hospitals. By Bonnie Darves. A few years ago, when the Minneapolis HMO Health Partners set out to improve care of members with congestive heart failure by using nurse case managers, the results were dramatic. Less than a year into the effort, the length of time between CHF patients' hospital admissions more than doubled. A 1995 Stanford University study of heart-attack patients, focused on risk-factor reduction, showed similar benefits of nurse case-manager intervention: Patients who worked with case managers after leaving the hospital had significantly lower low-density lipoprotein cholesterol levels and higher smoking-cessation rates than the control group. In addition, the cost of the intervention—about $500 per patient for nine hours of nursing time—was only one fifth the cost of a typical cardiac-rehabilitation program.. Although few would argue the benefits of case management—in which specially trained nurses work directly with patients to improve care continuity and reduce avoidable negative outcomes—physician groups have been slow to adopt the strategy. But now, as more groups enter capitated contracts, they are learning that case management, especially of high-risk patients or those with chronic disease and multiple ...

Palavras chave: , case, patients, management, case management, than, care, cost, case managers, groups, using, partners, managers, results, hospital, health, about, began using case, using case, began using,