An integrative review of nurse-led community-based case management effectiveness.

BACKGROUND: Accountable, continuous and patient-centred care in community-based settings is increasingly needed to reduce fragmented care, especially to reduce patient readmission rates. Case management has been proven effective in reducing healthcare costs and in increasing continuity of care, but its effectiveness in community-based settings is not clear. AIM: The aim of this integrative review is to examine the effectiveness of community-based case management programmes in improving patient outcomes.
METHODS: An integrative review of articles from PubMed, CINAHL and PsycInfo databases was undertaken to synthesize and analyse research about community-based case management and its outcomes. Studies looking for patient outcomes and empirical studies published since 2000 were included. A total 18 articles were retrieved from 2000 to 2013.
RESULTS: Most of the included studies were conducted in the USA, but international studies with quantitative approaches were reviewed (n = 6). The review revealed that community-based case management significantly reduced hospital access outcomes, especially readmissions and increased cost effectiveness, patient clinical outcomes and patient satisfaction. LIMITATIONS: This study did not isolate studies of patients with diseases or demographic characteristics in common, resulting in large variations in disease and demographic factors.
CONCLUSION: There is a base of evidence that community-based case management is effective. Because it provides quality, patient-centred care, case management should be used for major care coordination. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The benefits of community-based case management need to be announced to healthcare leaders and policymakers.