Outpatient case management for adults with medical illness and complex care needs

CONCLUSIONS: Recognizing the heterogeneity of study populations, interventions, and outcomes, we sought to elucidate the conditions under which CM was effective. We found that CM had limited impact on patient-centered outcomes, quality of care, and resource utilization among patients with chronic me...

Full description

Bibliographic Details
Main Author: Hickam, David H.
Corporate Authors: United States Agency for Healthcare Research and Quality, Oregon Health & Science University Evidence-based Practice Center, Effective Health Care Program (U.S.)
Format: eBook
Language:English
Published: Rockville, Md. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services [2013], 2013
Series:Comparative effectiveness review
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Description
Summary:CONCLUSIONS: Recognizing the heterogeneity of study populations, interventions, and outcomes, we sought to elucidate the conditions under which CM was effective. We found that CM had limited impact on patient-centered outcomes, quality of care, and resource utilization among patients with chronic medical illness
Due to the heterogeneity of outcomes, meta-analyses were not conducted. Systematic reviews were retrieved for reference, but data from pooled results of published reviews were not included in our analysis. RESULTS: Of the 5,645 citations identified, we screened and reviewed 1,201 full-length articles and included 153 articles representing 109 studies. Many of the published trials of CM examined programs that targeted specific patient conditions, and the approaches to CM were diverse. Overall, the interventions tested in the studies were associated with only small changes in patient-centered outcomes, quality of care, and resource utilization. While CM can improve some types of health care utilization, there are minimal effects on overall costs of care. For selected populations, the characteristics of successful interventions included intense CM with greater contact time, longer duration, face-to-face visits, and integration with patients' usual care providers.
OBJECTIVES: In this evidence review we evaluated outpatient case management (CM) as an intervention strategy for chronic illness management. We summarized the existing evidence related to the effectiveness of CM in improving patient-centered outcomes, quality of care, and resource utilization in adults with chronic medical illness and complex care needs. We also assessed the effectiveness of CM according to patient and intervention characteristics. DATA SOURCES: Articles were identified from searches of the MEDLINE(r), CINAHL(r), the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects. The databases were searched through August 2011. REVIEW METHODS: Two reviewers evaluated abstracts and articles against prespecified inclusion criteria. Eligible studies were quality rated and data were extracted, entered into tables, and summarized.
Item Description:"Contract No. 290-2007-10057-I.". - "January 2013."
Physical Description:1 PDF file (1 v. (various pagings) ill.)