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Case management for long-term conditions: implementation and processes

Published online by Cambridge University Press:  24 September 2009

SIOBHAN REILLY*
Affiliation:
National Institute for Health Research School for Primary Care Research, University of Manchester, Manchester, UK.
JANE HUGHES
Affiliation:
Personal Social Services Research Unit, University of Manchester, Manchester, UK.
DAVID CHALLIS
Affiliation:
Personal Social Services Research Unit, University of Manchester, Manchester, UK.
*
Address for correspondence: Siobhan Reilly, NIHR School for Primary Care Research, National Primary Care Research and Development Centre, Williamson Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: [email protected]

Abstract

This paper presents a structured literature review that focused on comprehensive case management by nurses for adults with long-term conditions living in the community. The emphases of the review are the implementation of case-management approaches, including its roles, core tasks and components, and the coverage and quality of the reported implementation data. Twenty-nine studies were included: the majority were concerned with case management for frail older people, and others focused on people with multiple chronic diseases, high-cost patients, or those at high risk of hospital admissions. All the studies reported that case managers undertook the core tasks of assessment, care planning and the implementation of the care plan, but there was more variation in who carried out case finding, monitoring, review and case closure. Few studies provided adequate implementation information. On the basis of the reviewed evidence, three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice, incorporating matters relating to the continuity of care, the intensity and breadth of involvement, and control over resources. It is recommended that future evaluations of case-management interventions include a comprehensive process component or, at the very least, that interventions should be more fully described.

Type
Articles
Copyright
Copyright © Cambridge University Press 2009

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