Administrative Characteristics of Comprehensive Prenatal Case Management Programs

Abstract

The purpose of this study was to examine comprehensive prenatal case management programs in terms of organizational, program, and process characteristics. Data from 66 program surveys of government agencies were used. Organizational capacity was measured as extent of organizational change and extent of interagency agreements. Program data included age and size of the program, reasons for having case management, and funding diversity. Process data were eight types of interventions. The most highly rated reason for having case management was to improve client outcomes. The greatest organizational change was in the area of the organizational structure, followed by financial status and types of services provided. Contracts with other agencies were rare. Agencies with more interagency contacts reported higher levels of change in the case management department and turnover among mid-level managers. Older programs had fewer employees. Approximately 49% of client contacts were not billed to Medicaid. Larger programs had significantly less time allocated to emotional support and coaching. Data on organizational characteristics, program, and process variables provide insights into comprehensive case management. Relationships among these variables underscore the importance of studying client outcomes within the context of program and organizational idiosyncrasies. Future studies of comprehensive prenatal case management should focus on cross-level questions.

The Work of Nurse Case Managers in a Cancer and Cardiovascular Disease Risk Screening Program

“…Our analyses of correlates of nurse case manager practice activities indicate that the nurse case Our findings increase understanding of the frequency of case manager practice activities reported by Tahan (1999) and Issel et al (2003) by making a distinction between client service and bureaucratic activities. We found that the most frequently performed activity by WHN nurse case managers was a bureaucratic task the other analyses did not distinguish-documenting services.…”

“…Other relevant organizational factors include client caseload size and required documentation of activities, as well as space, staff mix, availability of interpreters, and practice standards (Issel, 1997;Issel & Anderson, 2001;Issel et al, 2003). For example, Issel et al (2003) found that case managers working in larger programs spent significantly less time providing emotional support and more time on education than those working in smaller programs.…”

Healthy Start: Description of a Safety Net for Perinatal Support During Disaster Recovery

“…The case management system of care supported women's restoration by providing referrals and guidance through stressful issues of housing, income, and education. Although challenging to measure direct benefits, case management strategies have shown success in improving maternal and infant health outcomes for socially vulnerable women [38]. The intangible benefits of emotional support, coaching and encouragement by a personal provider may be especially helpful in post-disaster recovery [39].…”

Adolescent and Adult Clients in Prenatal Case Management: Differences in Problems and Interventions Used

“…A community-based, health-related service provided to medically or socially high-risk pregnant women for the purpose of improving birth and early infancy outcomes is prenatal case management (PCM), sometimes offered through home visiting [1]. Historically, local health departments in many states provided PCM as a Medicaid reimbursable service.…”

“…This study sought to answer two research questions: [1] what differences exist between adolescent and adult populations in the breadth of health and social problems addressed by PCM programs, and [2] what variation exists in the types of interventions used by PCM case managers to address adolescent and adult problems.…”