Examining End-of-Life Case Management: Systematic Review

Abstract

Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL) case management identified 17 research articles, with content analysis revealing two themes: (a) seeking to determine or establish the value of EOL case management and (b) identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

An Investigation of Factors Influencing High Usage of Medical and Long-Term Care Services in an Aging Society in Japan

“…In addition, research reports contributing to suppression of medical expenses by avoiding rehospitalization recommend early case management of patients with frequent hospitalization, elderly patients with acute myocardial infarction, and patients with specific diseases, including malignant tumors. [18][19][20][21] In these studies, the targets for case management were characterized by the frequent use of medical/long-term care services; they also had chronic diseases that had higher risks of emergency hospitalization if appropriate disease management or coordinated services were not provided. These results are consistent with the findings of our analysis on the characteristics of persons who have high medical/long-term care costs.…”

Case Management Effectiveness on Health Care Utilization Outcomes: A Systematic Review of Reviews

“…Of the remaining 47 reviews screened by title and abstract, 15 were identified for full text assessment. Eight of these were rejected because their outcomes (Sinha, Bessman, Flomenbaum, & Leff, 2011; Somme et al, 2012; Thomas, Wilson, Birch, & Woytowich, 2014; You et al, 2012), interventions (Burns et al, 2007; Eklund & Wilhelmson, 2009), or target populations (de Vet et al, 2013; Oeseburg, Wynia, Middel, & Reijneveld, 2009) did not meet the inclusion criteria. The seven remaining systematic reviews were selected and assessed for methodological quality.…”

A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition

“…One review found evidence on the positive impact of case management on reducing symptom distress, including one RCT. 43 Domain 2: Physical Aspects of Care KQ 2: What Is the Impact of Palliative Care Interventions on Physical Symptom Screening, Assessment, and Management of Patients? Forty-eight reviews met inclusion criteria for evaluating the impact of palliative care interventions on physical symptom screening, assessment, and management of patients.…”