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Effectiveness of case management interventions for frequent users of healthcare services: a scoping review

Hudon Catherine, Chouinard Maud-Christine, Lambert Mireille, Dufour Isabelle et Krieg Cynthia. (2016). Effectiveness of case management interventions for frequent users of healthcare services: a scoping review. BMJ Open, 6, (9), e012353.

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OBJECTIVE: Frequent users of healthcare services are a vulnerable population, often socioeconomically disadvantaged, who can present multiple chronic conditions as well as mental health problems. Case management (CM) is the most frequently performed intervention to reduce healthcare use and cost. This study aimed to examine the evidence of the effectiveness of CM interventions for frequent users of healthcare services.

DESIGN: Scoping review.

DATA SOURCES: An electronic literature search was conducted using the MEDLINE, Scopus and CINAHL databases covering January 2004 to December 2015. A specific search strategy was developed for each database using keywords 'case management' and 'frequent use'.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: To be included in the review, studies had to report effects of a CM intervention on healthcare use and cost or patient outcomes. Eligible designs included randomised and non-randomised controlled trials and controlled and non-controlled before-after studies. Studies limited to specific groups of patients or targeting a single disease were excluded. Three reviewers screened abstracts, screened each full-text article and extracted data, and discrepancies were resolved by consensus.

RESULTS: The final review included 11 articles evaluating the effectiveness of CM interventions among frequent users of healthcare services. Two non-randomised controlled studies and 4 before-after studies reported positives outcomes on healthcare use or cost. Two randomised controlled trials, 2 before-after studies and 1 non-randomised controlled study presented mitigated results. Patient outcomes such as drug and alcohol use, health locus of control, patient satisfaction and psychological functioning were evaluated in 3 studies, but no change was reported.

CONCLUSIONS: Many studies suggest that CM could reduce emergency department visits and hospitalisations as well as cost. However, pragmatic randomised controlled trials of adequate power that recruit the most frequent users of healthcare services are still needed to clearly confirm its effectiveness.

Type de document:Article publié dans une revue avec comité d'évaluation
Version évaluée par les pairs:Oui
Sujets:Sciences de la santé
Sciences de la santé > Sciences infirmières
Sciences de la santé > Sciences médicales
Sciences de la santé > Sciences médicales > Administration de la santé
Département, module, service et unité de recherche:Départements et modules > Département des sciences de la santé > Module des sciences infirmières
Mots-clés:case management, effectiveness, health services research, outcome assessment
Déposé le:24 avr. 2019 21:18
Dernière modification:24 avr. 2019 21:18
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