Standard case management of asthma in Sudan: a pilot project

BackgroundCase management, particularly in intensive form, has been widely introduced for the treatment of severe mental illness. However, the optimal intensity of case management has not been determined.AimsWe aimed to assess whether intensive case management (small case load) reduces hospitalisation and costs compared with standard case management.MethodDevelopment and rationale of a large randomised controlled trial comparing intensive case management (case load per worker? 15 patients) with standard case management (case load 30–35 patients)ResultsTwo-year outcome data will be obtained on patients representative of the seriously mentally ill in inner-city mental health services.ConclusionsThe study planned with 700 patients should be sufficient to detect small differences in the readmission of patients to hospital (10%), the number of days spent in hospital over a two-year period (10 days) and the average weekly cost of care per patient. The sample is large enough to compare the cost-effectiveness of intensive and standard case management in mild and severe disability and in people of African–Caribbean origin and White Caucasians.

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The peculiarities of patients with COVID-19 infection

The Moldovan Medical Journal ◽

10.52418/moldovan-med-j.64-5.21.05 ◽

2021 ◽

Vol 64 (5) ◽

pp. 27-32

Author(s):

Andrei Ungurean ◽

◽

Alina Malic ◽

Tatiana Osipov ◽

Evelina Lesnic ◽

...

Keyword(s):

Case Management ◽

Health Workers ◽

Clinical Manifestations ◽

Cross Sectional Study ◽

Cross Sectional ◽

Standard Case ◽

Positive Polymerase Chain Reaction ◽

The Republic ◽

Standard Case Management ◽

Age Over 60

Background: The surge demand and decreased availability of the health workers determined the designation of the Clinical Municipal Hospital of Phthisiopneumology (CMHP) into a hospital for the case-management of COVID-19 patients during the period of December 2020 – April 2021 for the treatment of the mild cases. The aim of the study was to assess the main peculiarities of the patients with COVID-19 through a cross-sectional study developed during the period February-April 2021 in the CMHP. Material and methods: A cross-sectional, analytical and prospective study was realized, which included 145 patients with COVID-19 hospitalized in the CMHP during February-April 2021. The inclusion criteria were: patient older 18 years, COVID-19 infection diagnosed by the pulmonologist with the positive polymerase chain reaction result for SARS-CoV-2 (COVID-19) and signed informed consent. Results: The peculiarities of patients with COVID-19 were dominated by the female sex, age over 60 years, residence in the urban districts of Chisinau and the infection acquired in the Republic of Moldova. Common clinical manifestations were: high temperature, profuse sweats, asthenia and headaches, productive cough, dyspnea, loss of smell or taste, and sore throat. The typical radiological findings such ground-glass pattern or consolidation with bilateral multifocal involvement were most frequent. Were cured most of the patients and the death rate was low. Conclusions: Peculiarities and clinical manifestations of the patients admitted in CMHP were typical for the COVID-19 infection. These findings did not show the real outcome of the standard case-management of the COVID-19 due to the restricted admission criteria.

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Cost-effectiveness of intensive v. standard case management for severe psychotic illness

The British Journal of Psychiatry ◽

10.1192/bjp.176.6.537 ◽

2000 ◽

Vol 176 (6) ◽

pp. 537-543 ◽

Cited By ~ 51

Author(s):

◽

Sarah Byford ◽

Matthew Fiander ◽

David J. Torgerson ◽

Julie A. Barber ◽

...

Keyword(s):

Cost Effectiveness ◽

Case Management ◽

Hospital Admissions ◽

Intensive Case Management ◽

Standard Case ◽

Severely Mentally Ill ◽

Significant Difference ◽

African Caribbean ◽

Standard Case Management ◽

The Cost

BackgroundIntensive case management is commonly advocated for the care of the severely mentally ill, but evidence of its cost-effectiveness is lacking.AimsTo investigate the cost-effectiveness of intensive compared with standard case management for patients with severe psychosis.Method708 patients with psychosis and a history of repeated hospital admissions were randomly allocated to standard (case-loads 30–35) or intensive (case-loads 10–15) case management. Clinical and resource use data were assessed over two years.ResultsNo statistically significant difference was found between intensive and standard case management in the total two-year costs of care per patient (means £24 550 and £22 700, respectively, difference £1850, 95% Cl – £1600 to £5300). There was no evidence of differential effects in African–Caribbean patients or in the most disabled. Psychiatric in-patient hospital stay accounted for 47% of the total costs, but neither such hospitalisation nor other clinical outcomes differed between the randomised groups.ConclusionReduced case-loads have no clear beneficial effect on costs, clinical outcome or cost-effectiveness. The policy of advocating intensive case management for patients with severe psychosis is not supported by these results.

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Measuring Disability, Need and Outcome in Australian Community Mental Health Services

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2000.00815.x ◽

2000 ◽

Vol 34 (5) ◽

pp. 850-855 ◽

Cited By ~ 21

Author(s):

Jill Gallagher ◽

Maree Teesson

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Case Management ◽

Community Mental Health Services ◽

Standard Case ◽

Australian Community ◽

Standard Case Management ◽

Assertive Case Management

Objective: This study trialled routine measurement of disability, need and outcome in mental health services within Sydney. Method: Fifteen community mental health clinicians with a combined caseload of 283 patients participated in the study. The Health of the Nation Outcome Scales (HoNOS) was used to assess disability and outcome and the patient and staff versions of the Camberwell Assessment of Need (CAN) were used to assess need. Results: The HoNOS and CAN appear to be promising contenders for routine use. Patients receiving assertive case management were rated as having higher levels of disability and need than patients receiving standard case management. Significant change in outcome was demonstrated with the HoNOS. Conclusions: To ensure the continued measurement of consumer outcome, issues such as staff education, training, and the development of computerised information systems should be addressed.

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Who is a Heavy Service User? Preliminary Development of a Screening Instrument for Prospective Consumers of a Mobile Intensive Treatment Team

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679709062689 ◽

1997 ◽

Vol 31 (5) ◽

pp. 744-750 ◽

Cited By ~ 2

Author(s):

Suzie Abbott ◽

Suzanne Smith ◽

Robert Clarke ◽

Cathy Curson ◽

Souza Janice de Gomes ◽

...

Keyword(s):

Case Management ◽

Objective Measure ◽

Screening Instrument ◽

Case Managers ◽

Intensive Treatment ◽

Service Users ◽

Treatment Team ◽

Standard Case ◽

Interview Format ◽

Standard Case Management

Objective: The mobile intensive treatment team (MITT) of the Valley Integrated Adult Mental Health Service in Brisbane, Australia, aims to provide services in the community to people with severe and persistent mental illness who have traditionally been heavily reliant on inpatient services (i.e. heavy service users). The MITT screening instrument (MITTSI) was developed to provide an objective measure to appropriately identify patients for referral to the service. Method: A literature review and a panel of multidisciplinary clinicians were consulted to identify a list of specific attributes that would assist in the detection of heavy service users. These attributes were then formulated into an easy-to-administer screening instrument entitled the MITTSI. The MITTSI was administered in an interview format to MITT case managers (intensive case management) and to case managers in standard case management with prospective MITT patients (prospective heavy service users). Results: Analyses of the responses indicated support for the MITTSI as a valid screening instrument in identifying heavy service users and for determining appropriate patients for referral to the MITT. Conclusion: The MITTSI is an easy-to-administer screening instrument which provides clear guidelines for inclusion and exclusion, and is an objective measure regarding the patients' urgency for referral to the MITT. Follow-up of the MIITSI within a broader, longer-term project will attempt to further refine the MITTSI and to further determine its validity. Outcomes will be published at a later stage.

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