It is widely accepted that case management is a valid approach for managing individuals with highly complex needs and long-term conditions. This highly readable report provides a welcome overview.
Structure of the report
This paper examines:
- What is case management?
- Core components?
- Case finding
- Assessment
- Care planning
- Care co-ordination
- Care closure
- How is case management being implemented?
- What are the benefits of case management when it is implemented effectively?
- What factors need to be in place for successful case management?
The evidence-base
Evidence on the impact of case management is ‘promising but mixed’ (Purdy 2010). Often there are multiple factors at play and it is difficult to attribute tangible impact (for instance a reduction in hospital utilisation) to the case management intervention. Further, case management programmes vary widely making comparisons difficult, impacts are hard to quantify and may not be measurable in the short term.
Nevertheless, there is evidence that case management can have a positive impact. The authors share examples in three key areas:
- service utilisation
- health care outcomes
- patient experience of care
Conclusions
The evidence for case management is mixed. Where implemented effectively it has significant potential to improve the experiences of users and carers, support better care outcomes, reduce the utilisation of hospital-based services, and enable a more cost-effective approach to care.
Well-targeted case management must be one of the core strategies used by emerging clinical commissioning groups to help tackle these challenges. As clinical commissioning groups begin to take on budgets for managing the health of their populations, they should prioritise the management of people with long-term conditions by commissioning effective case management programmes as part of a wider strategy for integrated care. They should develop strong and effective partnerships with local authorities through the new health and wellbeing boards, and engage early on with their clinical colleagues in primary, community and secondary care. This is likely to be the most successful route to implementing effective case management to meet the complex needs of people with long-term conditions.
Reference
Ross, S et al. Case management: What it is and how it can best be implemented? [PDF 246kb] King’s Fund, 17 Nov 2011
Purdy S, Avoiding hospital admissions: What does the research evidence say? [PDF 242KB] King’s Fund,16 Dec 2010
