Case Management for Patients with Complex Multimorbidity: Development and Validation of a Coordinated Intervention between Primary and Hospital Care

Data de publicació: 01/04/2017

Autors de IIS La Fe

• Salvador Tortajada Velert

  Autor

• María Soledad Giménez Campos

  Autor

• Julia Villar Lopez

  Autor

• Lucas Donat Castelló

  Autor

• Bernardo Valdivieso Martínez

  Autor

• Elisa María Soriano Melchor

  Autor

• Amparo Bahamontes Mulio

  Autor

• Juan Miguel García Gómez

  Autor

Autors aliens a IIS La Fe

• Faubel-Cava, R

Grups d'Investigació

• Unidad Mixta de Investigacion en TICs aplicadas a la reingeniería en procesos sociosanitarios (ERPSS)

  Investigador Principal

  María Eugenia Gas López

Abstract

In the past few years, healthcare systems have been facing a growing demand related to the high prevalence of chronic diseases. Case management programs have emerged as an integrated care approach for the management of chronic disease. Nevertheless, there is little scientific evidence on the impact of using a case management program for patients with complex multimorbidity regarding hospital resource utilisation. We evaluated an integrated case management intervention set up by community-based care at outpatient clinics with nurse case managers from a telemedicine unit. The hypothesis to be tested was whether improved continuity of care resulting from the integration of community-based and hospital services reduced the use of hospital resources amongst patients with complex multimorbidity. A retrospective cohort study was performed using a sample of 714 adult patients admitted to the program between January 2012 and January 2015. We found a significant decrease in the number of emergency room visits, unplanned hospitalizations, and length of stay, and an expected increase in the home care hospital-based episodes. These results support the hypothesis that case management interventions can reduce the use of unplanned hospital admissions when applied to patients with complex multimorbidity.

Keywords

• integrated care; case management; complex multimorbidity; chronic patient; hospital at home