scholarly journals Results of Nurse Case Management in Primary Heath Care: Bibliographic Review

2020 ◽  
Vol 17 (24) ◽  
pp. 9541
Author(s):  
Vicente Doménech-Briz ◽  
Rosario Gómez Romero ◽  
Isabel de Miguel-Montoya ◽  
Raúl Juárez-Vela ◽  
José Ramón Martínez-Riera ◽  
...  
Keyword(s):  
Case Management ◽  
Chronic Diseases ◽  
Hospital Admissions ◽  
Scientific Evidence ◽  
Case Manager ◽  
The Elderly ◽  
Levels Of Care ◽  
Nurse Case Manager ◽  
Complex Patients ◽  
Bibliographic Search

Background: The new characteristics of today’s population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. Objective: to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. Methods: Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. Inclusion criteria: articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. Results: A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. Conclusion: The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices.

scholarly journals Evaluating the Impact of a Risk Assessment System With Tailored Interventions in Germany: Protocol for a Prospective Study With Matched Controls (Preprint)

2019 ◽  
Author(s):  
Marten Pijl ◽  
Jorn op den Buijs ◽  
Andreas Landgraf
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Case Manager ◽  
The Elderly ◽  
Risk Scores ◽  
Care Utilization ◽  
Hospital Transport ◽  
Care Costs

BACKGROUND With a worldwide increase in the elderly population, and an associated increase in health care utilization and costs, preventing avoidable emergency department visits and hospitalizations is becoming a global priority. A personal emergency response system (PERS), consisting of an alarm button and a means to establish a live connection to a response center, can help the elderly live at home longer independently. Individual risk assessment through predictive modeling can help indicate what PERS subscribers are at elevated risk of hospital transport so that early intervention becomes possible. OBJECTIVE The aim is to evaluate whether the combination of risk scores determined through predictive modeling and targeted interventions offered by a case manager can result in a reduction of hospital admissions and health care costs for a population of German PERS subscribers. The primary outcome of the study is the difference between the number of hospitalizations in the intervention and matched control groups. METHODS As part of the Sicher Zuhause program, an intervention group of 500 PERS subscribers will be tracked for 8 months. During this period, risk scores will be determined daily by a predictive model of hospital transport, and at-risk participants may receive phone calls from a case manager who assesses the health status of the participant and recommends interventions. The health care utilization of the intervention group will be compared to a group of matched controls, retrospectively drawn from a population of PERS subscribers who receive no interventions. RESULTS Differences in health care utilization and costs between the intervention group and the matched controls will be determined based on reimbursement records. In addition, qualitative data will be collected on the participants’ satisfaction with the Sicher Zuhause program and utilization of the interventions offered as part of the program. CONCLUSIONS The study evaluation will offer insight into whether a combination of predictive analytics and case manager-driven interventions can help in avoiding hospital admissions and health care costs for PERS subscribers in Germany living at home independently. In the future, this may lead to improved quality of life and reduced medical costs for the population of the study. CLINICALTRIAL Deutsches Register Klinischer Studien (DRKS), DRKS00017328; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017328 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17584

scholarly journals Evaluating the Impact of a Risk Assessment System With Tailored Interventions in Germany: Protocol for a Prospective Study With Matched Controls

10.2196/17584 ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. e17584
Author(s):  
Marten Pijl ◽  
Jorn op den Buijs ◽  
Andreas Landgraf
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Intervention Group ◽  
Case Manager ◽  
The Elderly ◽  
Risk Scores ◽  
Care Utilization ◽  
Hospital Transport ◽  
Care Costs

Background With a worldwide increase in the elderly population, and an associated increase in health care utilization and costs, preventing avoidable emergency department visits and hospitalizations is becoming a global priority. A personal emergency response system (PERS), consisting of an alarm button and a means to establish a live connection to a response center, can help the elderly live at home longer independently. Individual risk assessment through predictive modeling can help indicate what PERS subscribers are at elevated risk of hospital transport so that early intervention becomes possible. Objective The aim is to evaluate whether the combination of risk scores determined through predictive modeling and targeted interventions offered by a case manager can result in a reduction of hospital admissions and health care costs for a population of German PERS subscribers. The primary outcome of the study is the difference between the number of hospitalizations in the intervention and matched control groups. Methods As part of the Sicher Zuhause program, an intervention group of 500 PERS subscribers will be tracked for 8 months. During this period, risk scores will be determined daily by a predictive model of hospital transport, and at-risk participants may receive phone calls from a case manager who assesses the health status of the participant and recommends interventions. The health care utilization of the intervention group will be compared to a group of matched controls, retrospectively drawn from a population of PERS subscribers who receive no interventions. Results Differences in health care utilization and costs between the intervention group and the matched controls will be determined based on reimbursement records. In addition, qualitative data will be collected on the participants’ satisfaction with the Sicher Zuhause program and utilization of the interventions offered as part of the program. Conclusions The study evaluation will offer insight into whether a combination of predictive analytics and case manager-driven interventions can help in avoiding hospital admissions and health care costs for PERS subscribers in Germany living at home independently. In the future, this may lead to improved quality of life and reduced medical costs for the population of the study. Trial Registration Deutsches Register Klinischer Studien (DRKS), DRKS00017328; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017328 International Registered Report Identifier (IRRID) DERR1-10.2196/17584

Realigning the Communication Paradigm in Nursing Case Management

2004 ◽  
Vol 5 (2) ◽  
pp. 67-72 ◽  
Author(s):  
Mary Ann Anderson ◽  
Lelia B. Helms ◽  
Norma R. Kelly
Keyword(s):  
Case Management ◽  
Hospital Setting ◽  
Case Manager ◽  
Pilot Project ◽  
Organizational Outcomes ◽  
Case Managers ◽  
Hub And Spoke ◽  
Policy Makers ◽  
Nurse Case Manager ◽  
Communication Dynamics

Communication underlies all of case management (CM), and better comprehension of the processes of communication within the context of the CM role may facilitate positive patient and organizational outcomes, and assist providers and policy makers in designing effective CM systems. Thus, the purpose of this qualitative, pilot project was to explore dimensions of communication of the nurse case manager role within a hospital setting. The results describe a “hub and spoke” model of communications and suggest the utility of this familiar model for understanding the communication dynamics for those who work as nursing case managers in hospital settings. Findings suggest that nurse case managers are at various times both advocates and mediators—communications roles that may encompass somewhat contradictory demands and perspectives.

scholarly journals The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽  
2021 ◽  
pp. 146040862094972
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory ◽  
Gavin Gordon ◽  
Fiona Smith ◽  
Andrew Jennings
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Hospital Admissions ◽  
The Elderly ◽  
Primary Outcome Measure ◽  
Time To Death ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

scholarly journals Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juopperi Samuli ◽  
Sund Reijo ◽  
Rikkonen Toni ◽  
Kröger Heikki ◽  
Sirola Joonas
Keyword(s):  
Chronic Diseases ◽  
Musculoskeletal Disorders ◽  
Population Sample ◽  
The Elderly ◽  
Primary Objective ◽  
Baseline Body Mass Index ◽  
Functional Tests ◽  
Physical Capability ◽  
Study Population

Abstract Background Good physical capability is an important part of healthy biological ageing. Several factors influencing physical capability have previously been reported. Long-term reports on physical capability and the onset of clinical disorders and chronic diseases are lacking. Decrease in physical capacity has been shown to increase mortality. This study focuses on the prevalence of chronic diseases. The primary objective of the study was to reveal the association between physical capability and morbidity. Secondary objectives included the validity of self-reported physical capability and the association between baseline physical capability and mortality. Methods The OSTPRE (Kuopio Osteoporosis Risk Factor and Prevention Study) prospective cohort involved all women aged 47–56 years residing in the Kuopio Province, Finland in 1989. Follow-up questionnaires were mailed at five-year intervals. Physical capability questions were first presented in 1994. From these women, we included only completely physically capable subjects at our baseline, in 1994. Physical capability was evaluated with five scale self-reports at baseline and in 2014 as follows: completely physically capable, able to walk but not run, can walk up to 1000 m, can walk up to 100 m and temporarily severely incapable. The prevalences of selected chronic diseases, with a minimum prevalence of 10% in 2014, were compared with the change in self-reported physical capability. Additionally, associations between long-term mortality and baseline physical capability of the whole 1994 study population sample were examined with logistic regression. The correlation of self-reported physical capability with functional tests was studied cross-sectionally at the baseline for a random subsample. Results Our study population consisted of 6219 Finnish women with a mean baseline age of 57.0 years. Self-reported physical capability showed statistically significant correlation with functional tests. Cardiovascular diseases and musculoskeletal disorders show the greatest correlation with decrease of physical capability. Prevalence of hypertension increased from 48.7% in the full physical capability group to 74.5% in the “able to walk up to 100 metres” group (p < 0.001). Rheumatoid arthritis showed a similar increase from 2.1 to 7.4% between these groups. Higher baseline body mass index (BMI) decreases long-term capability (P < 0.001). Women reporting full physical capability at baseline had a mortality rate of 15.1%, in comparison to 48.5% in women within the “able to walk up to 100 m” group (p = 0.357). Mortality increased steadily with worsening baseline physical capability. Conclusions The results of this study show that chronic diseases, particularly cardiovascular and musculoskeletal disorders, correlate with faster degradation of physical capability in the elderly. Similar results are shown for increase in BMI. We also demonstrate that the risk of mortality over a 20-year period is higher in individuals with poor baseline physical capability.

scholarly journals Reimbursement for Pediatric Diabetes Intensive Case Management: A Model for Chronic Diseases?

PEDIATRICS ◽  
2003 ◽  
Vol 113 (1) ◽  
pp. e47-e50 ◽  
Author(s):  
J. K. Beck ◽  
K. J. Logan ◽  
R. M. Hamm ◽  
S. M. Sproat ◽  
K. M. Musser ◽  
...  
Keyword(s):  
Case Management ◽  
Chronic Diseases ◽  
Intensive Case Management ◽  
Pediatric Diabetes

Case Management in Occupational Rehabilitation: Would the Real Case Manager Please Stand Up?

1995 ◽  
Vol 1 (2) ◽  
pp. 104-117 ◽  
Author(s):  
Dianna T. Kenny
Keyword(s):  
Case Management ◽  
Case Manager ◽  
Occupational Rehabilitation ◽  
Case Managers ◽  
Injured Workers ◽  
Policy And Practice ◽  
Post Injury ◽  
Proper Role ◽  
Key Stakeholders ◽  
Successful Case

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

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