Effectiveness of case management interventions for frequent users of healthcare services: a scoping review
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. Thi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2016-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/6/9/e012353.full |
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| author | Catherine Hudon Maud-Christine Chouinard Isabelle Dufour Mireille Lambert Cynthia Krieg |
| author_facet | Catherine Hudon Maud-Christine Chouinard Isabelle Dufour Mireille Lambert Cynthia Krieg |
| author_sort | Catherine Hudon |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-bdcc62e1b51b4d87b618ab0ed0ccd516 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2016-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-bdcc62e1b51b4d87b618ab0ed0ccd5162025-02-01T16:20:10ZengBMJ Publishing GroupBMJ Open2044-60552016-09-016910.1136/bmjopen-2016-012353Effectiveness of case management interventions for frequent users of healthcare services: a scoping reviewCatherine Hudon0Maud-Christine Chouinard1Isabelle Dufour2Mireille Lambert3Cynthia Krieg4Département de Médecine de Famille et Médecine d’Urgence, Université de Sherbrooke, Sherbrooke, Quebec, CanadaNursing Faculty, Université de Montréal, Montreal, Québec, Canada3 Faculty of Nursing, Sherbrooke University, Sherbrooke, Quebec, canada1 Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada5Département de pharmacologie-physiologie, Université de Sherbrooke, Sherbrooke, Québec, CanadaObjective 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.https://bmjopen.bmj.com/content/6/9/e012353.full |
| spellingShingle | Catherine Hudon Maud-Christine Chouinard Isabelle Dufour Mireille Lambert Cynthia Krieg Effectiveness of case management interventions for frequent users of healthcare services: a scoping review BMJ Open |
| title | Effectiveness of case management interventions for frequent users of healthcare services: a scoping review |
| title_full | Effectiveness of case management interventions for frequent users of healthcare services: a scoping review |
| title_fullStr | Effectiveness of case management interventions for frequent users of healthcare services: a scoping review |
| title_full_unstemmed | Effectiveness of case management interventions for frequent users of healthcare services: a scoping review |
| title_short | Effectiveness of case management interventions for frequent users of healthcare services: a scoping review |
| title_sort | effectiveness of case management interventions for frequent users of healthcare services a scoping review |
| url | https://bmjopen.bmj.com/content/6/9/e012353.full |
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