OBJECTIVE: To describe the characteristics of case management in terms of population served, interventions, use of services and outcomes such as mortality, readmissions, pressure ulcers, falls, drug problems and institutionalization. METHOD: Follow-up study of a cohort, from the RANGECOM Multicentric Registry of Andalusia. The study population were patients included in the case management services of Health Centres and their family caregivers. RESULTS: Data from 835 patients with a mean age of 76.8years (SD:12.1), 50.24% women, are presented. They had an important comorbidity (Charlson 3.1, SD:2.5) and high dependence (Barthel 37.5, SD:31.4). Sixty-two point two percent of the interventions deployed by the case managers were grouped into three domains: behavioural (26.0%), health system (20.2%) and safety (14.1%). Mortality was 34.4% and hospital admissions 38.1%. Patients with more hospital readmissions had more visits to the Emergency Department (OR:1.41; 95%CI: 1.22-1.63), more telephone interventions by case managers (OR:1.12; 95%CI: 1.02-1.24) and imaging tests (OR:1.37; 95%CI: 1.17-1.60), together with greater caregiver burden (OR:1.31; 95%CI: 1.08-1.59), the presence of medical devices at home (OR:1.69; 95%CI: 1.00-2.87) and received less "Case Management" intervention. CONCLUSIONS: The patients who absorb the demand of case management nurses present high complexity, for which they deploy behavioural interventions, navigation through the health system and clinical safety.
OBJECTIVE: To describe the characteristics of case management in terms of population served, interventions, use of services and outcomes such as mortality, readmissions, pressure ulcers, falls, drug problems and institutionalization. METHOD: Follow-up study of a cohort, from the RANGECOM Multicentric Registry of Andalusia. The study population were patients included in the case management services of Health Centres and their family caregivers. RESULTS: Data from 835 patients with a mean age of 76.8years (SD:12.1), 50.24% women, are presented. They had an important comorbidity (Charlson 3.1, SD:2.5) and high dependence (Barthel 37.5, SD:31.4). Sixty-two point two percent of the interventions deployed by the case managers were grouped into three domains: behavioural (26.0%), health system (20.2%) and safety (14.1%). Mortality was 34.4% and hospital admissions 38.1%. Patients with more hospital readmissions had more visits to the Emergency Department (OR:1.41; 95%CI: 1.22-1.63), more telephone interventions by case managers (OR:1.12; 95%CI: 1.02-1.24) and imaging tests (OR:1.37; 95%CI: 1.17-1.60), together with greater caregiver burden (OR:1.31; 95%CI: 1.08-1.59), the presence of medical devices at home (OR:1.69; 95%CI: 1.00-2.87) and received less "Case Management" intervention. CONCLUSIONS: The patients who absorb the demand of case management nurses present high complexity, for which they deploy behavioural interventions, navigation through the health system and clinical safety.
Keywords:
Advanced practice nursing; Case management; Clasificación de intervenciones de enfermería; Enfermería de práctica avanzada; Gestión de casos; Multimorbidity; Multimorbilidad; Nursing intervention classification; Registries; Registros
Authors: Gonzalo Duarte-Climents; María Begoña Sánchez-Gómez; José Ángel Rodríguez-Gómez; Cristobalina Rodríguez-Álvarez; Antonio Sierra-López; Armando Aguirre-Jaime; Juan Gómez-Salgado Journal: Int J Environ Res Public Health Date: 2019-05-29 Impact factor: 3.390
Authors: Vicente Doménech-Briz; Rosario Gómez Romero; Isabel de Miguel-Montoya; Raúl Juárez-Vela; José Ramón Martínez-Riera; María Isabel Mármol-López; María Virtudes Verdeguer-Gómez; Álvaro Sánchez-Rodríguez; Vicente Gea-Caballero Journal: Int J Environ Res Public Health Date: 2020-12-20 Impact factor: 3.390
Authors: Desirée Jerez-Barranco; Laura Gutiérrez-Rodríguez; Juan Carlos Morilla-Herrera; Magdalena Cuevas Fernandez-Gallego; Remedios Rojano-Perez; María Dolores Camuñez-Gomez; José Luis Sanchez-Del Campo; Silvia García-Mayor Journal: BMC Nurs Date: 2022-06-23