Reducing utilisation of hospital services by case management: a randomised controlled trial

Abstract

A 12-month randomised controlled trial was conducted in Hong Kong to evaluate the effectiveness of case management provided to a group of home-dwelling, frail elderly patients (control group: n = 47; intervention group: n = 45) in terms of utilisation of hospital services by these patients.Significant reductions (significance at P р 0.05) in mean total number of hospital bed-days (P < 0.001), mean total episodes of hospital admissions (P < 0.001), and mean total number of attendances at the outpatient department (P < 0.05) were observed when the baseline and post-intervention differences between the intervention and control groups were compared.The study demonstrated that utilisation of hospital services could be significantly reduced when a group of elderly patients and their caregivers received timely interventions and appropriate

Description of Advanced Practice Nurses Interventions Through the Nursing Interventions Classification in Different Care Settings for Older People: A Qualitative Study

“…Sixty‐four interventions repeated 171 times were extracted (Table ) from 18 studies (Blue et al., ; Bouman et al, ; Carroll & Rankin, ; Duffy, Hoskins, & Dudley‐Brown, ; Elley et al., ; Imhof, Naef, Wallhagen, Schwarz, & Mahrer‐Imhof, ; Leung, Liu, Chow, & Chi, ; Leung, Yau, et al, ; McCorkle et al., ; Melis et al., ; Parsons et al., ; Rondinini et al., ; Rosted, Poulsen, Hendriksen, Petersen, & Wagner, ; Schein, Gagnon, Chan, Morin, & Grondines, ; Stuck et al., , ; Trief, ). The density of the interventions varied from 1 to 10.…”

Determining caseloads in the community care of frail older people with chronic illnesses

“…2003). Certainly, smaller caseloads in community case management for frail older people reduce hospital‐related healthcare expenditure (Leung et al. 2004, Onder et al.…”

“…A risk assessment tool to differentiate how much case management frail older people require has been trialled using a staff: client ratio of 1:20, although evaluations are yet to be reported (Hadjistavropoulos et al 2003). Certainly, smaller caseloads in community case management for frail older people reduce hospital-related healthcare expenditure (Leung et al 2004, Onder et al 2007, but rely on a supportive healthcare system. Case managers have been reported to be frustrated by the lack of agency and community policies and resources to allow case managers to properly support people in their homes (Diem et al 2001).…”

From Hospital to Home After Cardiac Surgery

“…Community nursing care is also linked to decrease in the length of hospitalization, the rate of readmission of patients, and the number of consultations at emergency services (Harrison et al, 2002;Leung, Yau, et al, 2004;Phaneuf, 2005). From an organizational point of view, the utilization of a community nursing care management model could foster better identification of patient needs (Nolan et al, 1998;Phaneuf, 2005), planning of services (Nolan et al, 1998), better work organization for the professional staff (Phaneuf, 2005), a decrease in costs Leung, Yau, et al, 2004;Nolan et al, 1998;Phaneuf, 2005), and an increase in nursing leadership (Nolan et al, 1998).…”