Case management

What is case management?

Case management is a community-based program in which a nurse, social worker or other clinician oversees the treatment programs and overall wellbeing of patients. Intensive case management is a variation on standard case management, where case managers have a smaller load, generally fewer than 20 patients. It is often used to care for people at high risk of hospital readmission. Assertive community treatment is a form of intensive case management with a focus on service coordination involving extensive integration with multidisciplinary teams who share a small caseload.

What is the evidence for case management?

Compared to standard care, high quality evidence shows that intensive case management is associated with increased contact with psychiatric care, increased independent living, and a lower likelihood of being admitted to hospital or dropping out of treatment for up to 12 months. Moderate quality evidence suggests it may also improve quality of life and general functioning, and decrease homelessness for up to 6 months. By 7 to 12 months there is decreased unemployment and contact with police. After 12 months, there is an increased likelihood of living in stable accommodation, with better functioning, improved symptoms, and increased medication compliance. Moderate to high quality evidence suggests intensive case management reduces long-term study dropout rates and medication non-adherence more than standard case management. For patients with a dual diagnosis (substance misuse and psychiatric disorder), moderate to low quality evidence suggests no significant benefit of intensive case management has over standard care for study retention, hospitalisation or service use, substance use, quality of life or functioning.

September 2020

Last updated at: 2:50 am, 11th September 2020
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