Consequences of clinical case management for caregivers: a systematic review

Abstract

Despite the numerous methodological challenges in the assessment of such complex social interventions, our results show that case management programs can be beneficial for caregivers of dementia patients and that positive results for patients are achieved without increasing caregivers' burden. Copyright © 2017 John Wiley & Sons, Ltd.

How to Reduce Excessive Use of the Health Care Service in Medical Aid Beneficiaries: Effectiveness of Community-Based Case Management

“…Health-related QOL was measured by different instruments in the groups, and the perception of self-care was not investigated in the repeated use target group. Among the client-centered outcomes, health-related QOL improved after the case management in all groups significantly, which is consistent with other studies [13,20,21]. Moreover, improvements in the client-centered outcomes led to reductions in healthcare utilization and costs.…”

How to reduce excessive use of health care service in medical aid beneficiaries: an economic impact of community-based case management

“…All primary outcomes such as health-related QOL, personal power of health care, rational medical utilization, and support system were found to be effectively improved, and the results are consistent with the results of previous studies [14,[16][17][18]. However, it was difficult to compare all the indicators related to program outcome, because health-related QOL was measured by different instruments by groups, and other indicators were not investigated in the intensive care group.…”

What works in managing complex conditions in older people in primary and community care? A state‐of‐the‐art review

“…The integration of teams appeared to be more important than composition. Greater integration of case managers was associated with better care quality for people with dementia when classified according to links within the patient care team and with wider acute and long‐term care structures (Somme et al., 2012) and better outcomes in frailty when narratively assessed as good communication and close cooperation between case managers and healthcare professionals (Oeseburg, Wynia, Middel, & Reijneveld, 2009), although not for carers of people with dementia when integration was assessed based on case managers' links with other types of care (Corvol et al., 2017). Removing studies described as integrated diabetes care from a meta‐analysis led to null effects upon depression and HbA1c levels in collaborative diabetes and depression care (Atlantis et al., 2014).…”

“…Seven reviews quantified it purely in terms of frequency, defining high intensity as one or more contacts a month for more than 3 months (Coulter et al., 2015), six or more face‐to‐face contacts a week (Fens et al., 2013), six or more home visits (Hildebrand, 2015), more than 14.4 contacts per 12 months (Backhouse et al., 2017) or one or more visits a month (Baker et al., 2018); and one used number of sessions in a meta‐regression (Ekers et al., 2013). Three reviews scored intensity according to multidisciplinary input, number of scheduled visits and duration (Beswick et al., 2010) and caseload, patient complexity, frequency of visits and range of services provided (Corvol et al., 2017) or a combination of 18 different criteria (Somme et al., 2012). A final review simply used the authors' subjective judgement (Low et al., 2011).…”

“…More intense interventions appeared to have little effect on frailty in comparison to usual care (Beswick et al., 2010). However, for carers, older people with mixed LTCs and following stroke, higher intensity was associated with greater effectiveness over usual care for HbA1c levels (Coulter et al., 2015), quality of life (Fens et al., 2013), health‐related quality of life, depression and anxiety (Hildebrand, 2015), caregiver outcomes (Corvol et al., 2017) and more positive outcomes overall (Low et al., 2011). Evidence was conflicting for dementia, finding no effects upon hospitalisation, institutionalisation or mortality (Backhouse, Dickens, Richards, & McCabe, 2015) and some positive effects on clinical outcomes (Somme et al., 2012); and for multimorbidity, for which there were mixed effects upon depression (Baker et al., 2018; Ekers et al., 2013).…”