scholarly journals HIV testing and ART initiation among partners, family members, and high-risk associates of index clients participating in the CommLink linkage case management program, Eswatini, 2016–2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261605
Author(s):  
Daniel Williams ◽  
Duncan MacKellar ◽  
Makhosazana Dlamini ◽  
Johnita Byrd ◽  
Lenhle Dube ◽  
...  
Keyword(s):  
High Risk ◽  
Case Management ◽  
Hiv Testing ◽  
Phase Ii ◽  
Family Members ◽  
Management Program ◽  
Hiv Positive ◽  
Case Management Program ◽  
Art Initiation ◽  
Biological Children

To help diagnose and initiate antiretroviral therapy (ART) for ≥95% of all persons living with HIV (PLHIV), the World Health Organization (WHO) recommends offering HIV testing to biological children, and sexual and needle-sharing partners of all PLHIV (index-client testing, ICT). Many index clients, however, do not identify or have contactable partners, and often substantially fewer than 95% of HIV-positive partners initiate ART soon after index testing. To help improve early HIV diagnosis and ART initiation in Eswatini (formerly Swaziland), we implemented a community-based HIV testing and peer-delivered, linkage case management program (CommLink) that provided ICT as part of a comprehensive package of WHO recommended linkage services. CommLink was implemented June 2015 –March 2017 (Phase I), and April 2017 –September 2018 (Phase II). In addition to biological children and partners, HIV testing was offered to adult family members (Phases I and II) and high-risk associates including friends and acquaintances (Phase II) of CommLink index clients. Compared with Phase I, in Phase II proportionally more CommLink clients disclosed their HIV-infection status to a partner or family member [94% (562/598) vs. 75% (486/652)], and had ≥1 partners, family members, or high-risk associates (contacts) tested through CommLink [41% (245/598) vs. 18% (117/652)]. Of 537 contacts tested, 253 (47%) were HIV-positive and not currently in HIV care, including 17% (17/100) of family members aged <15 years, 42% (78/187) of non-partner family members aged ≥15 years, 60% (73/121) of sexual partners, and 66% (85/129) of high-risk associates. Among 210 HIV-positive contacts aged ≥15 years who participated in CommLink, nearly all received recommended linkage services including treatment navigation (95%), weekly telephone follow-up (93%), and ≥3 counseling sessions (94%); peer counselors resolved 76% (306/404) of identified barriers to care (e.g., perceived wellness); and 200 (95%) initiated ART at a healthcare facility, of whom 196 (98%) received at least one antiretroviral refill before case-management services ended. To help countries achieve ≥90% ART coverage among all PLHIV, expanding ICT for adult family members and high-risk associates of index clients, and providing peer-delivered linkage case management for all identified PLHIV, should be considered.

A Nursing Case Management Program for Low-Income High-Risk Diabetic Clients

2006 ◽  
Vol 11 (2) ◽  
pp. 90???98 ◽  
Author(s):  
Carolyn S. Crow ◽  
Shelley A. Lakes ◽  
Melondie R. Carter
Keyword(s):  
High Risk ◽  
Case Management ◽  
Low Income ◽  
Management Program ◽  
Case Management Program

Propensity to Succeed: A New Method to Target and Outreach to Members Most Likely to Benefit From A High Risk Case Management Program

2013 ◽  
Vol 23 (9) ◽  
pp. 590
Author(s):  
Kevin Hawkins ◽  
Ronald J. Ozminkowski ◽  
Asif Mujahid ◽  
Timothy S. Wells ◽  
Gandhi R. Bhattarai ◽  
...  
Keyword(s):  
High Risk ◽  
Case Management ◽  
Management Program ◽  
New Method ◽  
Case Management Program ◽  
High Risk Case

Impactability models for high-need high-cost patients: Evaluating their effectiveness in reducing Medicare ACO payments and hospital events (Preprint)

2021 ◽  
Author(s):  
Maureen Smith ◽  
Menggang Yu ◽  
Jared Huling ◽  
Xinyi Wang ◽  
Allie DeLonay ◽  
...  
Keyword(s):  
High Risk ◽  
Case Management ◽  
Management Program ◽  
Moderate Risk ◽  
Case Management Program ◽  
Care Clinic ◽  
High Risk Patients ◽  
Risk Patients ◽  
High Benefit ◽  
The Impact

BACKGROUND Impactability modeling promises to help solve the nationwide crisis in caring for high-need high-cost patients by matching specific case management programs with patients using a “benefit” or “impactability” score, but there are limitations in tailoring each model to a specific program and population. OBJECTIVE We evaluated the impact on Medicare ACO savings from developing a benefit score for patients enrolled in an historic case management program, then prospectively implementing the score and evaluating the results in a new case management program. METHODS We conducted a longitudinal cohort study of 76,140 patients in a Medicare ACO with multiple before-and-after measures of the outcome using linked electronic health records and Medicare claims data from 2012 to 2019. There were 489 patients in the historic case management program and 1,550 matched comparison patients; 830 patients in the new program with 2,368 matched comparisons. The historic program targeted high-risk patients and assigned a centrally-located registered nurse and social worker to each patient. The new program targets high- and moderate-risk patients and assigns a nurse physically located in a primary care clinic. Our primary outcomes were any unplanned hospital events (admissions, observation stays, and ED visits), count of event-days, and Medicare payments. RESULTS In the historic program, as expected, high-benefit patients enrolled in case management had fewer events, fewer event-days, and an average $1.15 million reduction in Medicare payments per 100 patients over the subsequent year when compared to matched comparisons. For the new program, high-benefit high-risk patients enrolled in case management had fewer events, while high-benefit moderate-risk patients enrolled in case management did not differ from matched comparisons. CONCLUSIONS Although there was evidence that a benefit score could be extended to a new case management program for similar (i.e., high-risk) patients, there was no evidence that it could be extended to a moderate-risk population. Extending a score to a new program and population should include evaluation of program outcomes within key subgroups. With the increased attention to value-based care, policy makers and measure developers should consider ways to incorporate impactability modeling into program design and evaluation. CLINICALTRIAL N/A

Nutritional screening in a case management program for community-living older individuals at high risk of hospital admission

2018 ◽  
Vol 9 (5) ◽  
pp. 691-696
Author(s):  
S. Forcano-Sanjuan ◽  
E. Soriano-Melchor ◽  
B. Valdivieso-Martinez ◽  
V. Ruiz-García ◽  
J. F. Merino-Torres ◽  
...  
Keyword(s):  
High Risk ◽  
Case Management ◽  
Hospital Admission ◽  
Management Program ◽  
Community Living ◽  
Older Individuals ◽  
Nutritional Screening ◽  
Case Management Program

Peer assisted HIV self-testing increases positivity rates among key populations in Burundi: descriptive analysis of routine programmatic data (Preprint)

2020 ◽  
Author(s):  
Tiffany Lillie ◽  
Dorica Boyee ◽  
Gloriose Kamariza ◽  
Alphonse Nkunzimana ◽  
Dismas Gashobotse ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sex Workers ◽  
Descriptive Analysis ◽  
Case Finding ◽  
Hiv Positive ◽  
Key Populations ◽  
Standard Testing ◽  
Art Initiation ◽  
Treatment Standard ◽  
Self Testing

BACKGROUND In Burundi, given the low testing numbers among key populations, peer assisted HIV self-testing (HIVST) was initiated for female sex workers (FSWs), men who have sex with men (MSM), and transgender people (TG) to provide another testing option. HIVST was provided by existing peer outreach workers (POWs) who were trained to provide support before, during, and after the administration of the test. People who screened reactive were referred and actively linked to confirmatory testing, and those confirmed positive were linked to treatment. Standard testing included HIV testing by clinical staff either at mobile clinics or in facilities. OBJECTIVE The objective was to improve access to HIV testing to underserved KP members, increase HIV positivity rates, and link those who were confirmed HIV positive with life-saving treatment for epidemic control. METHODS A descriptive analysis of routine programmatic data was conducted from a nine-month implementation period (June 2018-March 2019) of peer assisted HIVST among FSWs, MSM, and TG in six provinces where the USAID- and PEPFAR-funded LINKAGES Burundi project worked. Chi-squared tests were used to compare case-finding rates among individuals tested through HIVST versus standard testing. RESULTS A total of 2,198 HIVST test kits were administered (1,791 FSWs, 363 MSM, 44 TG). Three hundred and sixty-six people (17%) were reactive to HIV screening (296 FSWs, 60 MSM, 10 TG); 314 (14%) were confirmed HIV positive (257 FSWs, 47 MSM, 10 TG); and 301 (96%) (251 FSWs, 40 MSM, 10 TG) of those confirmed were initiated on treatment. HIV case-finding rates were significantly higher with HIVST compared to standard testing for FSW and MSM but not TG: FSWs (14% vs. 9%, P < .001); MSM (13% vs. 4%, P < .001); and TG (23% vs. 17%, P > .10). ART initiation rates were significantly lower for MSM confirmed HIV positive through HIVST than through standard testing (85% vs. 99%, P < .001) but not among FSWs or TG (FSWs: 98% vs. 97%, P > .10; TG: 100% vs. 100%). CONCLUSIONS The results demonstrate the potential effectiveness of HIVST in identifying individuals who are living with HIV.

scholarly journals Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters

2020 ◽  
Vol 17 (7) ◽  
pp. 2599
Author(s):  
Min-Hyuk Kim ◽  
Jinhee Lee ◽  
Hyunjean Noh ◽  
Jin-Pyo Hong ◽  
Hyun Kim ◽  
...  
Keyword(s):  
Case Management ◽  
Teaching Hospital ◽  
Suicide Attempts ◽  
Management Program ◽  
Continuous Case ◽  
Case Management Program ◽  
Suicide Attempters ◽  
Flexible Approach ◽  
Risk Of Death ◽  
Management Group

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13–0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09–0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts.

An Evaluation of a Client-Centered Case Management Program for Elder Abuse

2000 ◽  
Vol 11 (4) ◽  
pp. 5-22 ◽  
Author(s):  
Dana Vladescu ◽  
Kimberly Eveleigh ◽  
Jenny Ploeg ◽  
Christopher Patterson
Keyword(s):  
Case Management ◽  
Elder Abuse ◽  
Management Program ◽  
Case Management Program
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