RT Journal Article
SR Electronic
T1 Characteristics of Case Management in Primary Care Associated With Positive Outcomes for Frequent Users of Health Care: A Systematic Review
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 448
OP 458
DO 10.1370/afm.2419
VO 17
IS 5
A1 Catherine Hudon
A1 Maud-Christine Chouinard
A1 Pierre Pluye
A1 Reem El Sherif
A1 Paula Louise Bush
A1 Benoît Rihoux
A1 Marie-Eve Poitras
A1 Mireille Lambert
A1 Hervé Tchala Vignon Zomahoun
A1 France Légaré
YR 2019
UL http://www.annfammed.org/content/17/5/448.abstract
AB PURPOSE Case management (CM) interventions are effective for frequent users of health care services, but little is known about which intervention characteristics lead to positive outcomes. We sought to identify characteristics of CM that yield positive outcomes among frequent users with chronic disease in primary care.METHODS For this systematic review of both quantitative and qualitative studies, we searched MEDLINE, CINAHL, Embase, and PsycINFO (1996 to September 2017) and included articles meeting the following criteria: (1)population: adult frequent users with chronic disease, (2)intervention: CM in a primary care setting with a postintervention evaluation, and (3)primary outcomes: integration of services, health care system use, cost, and patient outcome measures. Independent reviewers screened abstracts, read full texts, appraised methodologic quality (Mixed Methods Appraisal Tool), and extracted data from the included studies. Sufficient and necessary CM intervention characteristics were identified using configurational comparative methods.RESULTS Of the 10,687 records retrieved, 20 studies were included; 17 quantitative, 2 qualitative, and 1 mixed methods study. Analyses revealed that it is necessary to identify patients most likely to benefit from a CM intervention for CM to produce positive outcomes. High-intensity intervention or the presence of a multidisciplinary/interorganizational care plan was also associated with positive outcomes.CONCLUSIONS Policy makers and clinicians should focus on their case-finding processes because this is the essential characteristic of CM effectiveness. In addition, value should be placed on high-intensity CM interventions and developing care plans with multiple types of care providers to help improve patient outcomes.