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Community-Based Advanced Case Management for Patients with Complex Multimorbidity and High Medical Dependence: A Longitudinal Study

Author

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  • Kana Kazawa

    (Department of Medicine for Integrated Approach to Social Inclusion, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
    Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan)

  • Michiko Moriyama

    (Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan)

Abstract

This longitudinal study aimed to evaluate a community-based and nurse-led advanced case management model centered on disease management. Participants were chronically ill patients aged 20 years and older who were highly dependent on medical care. The case management group (CMG) received nurse-led advanced case management, and the comparison group (CG) was selected by matching estimated propensity scores with the CMG. We compared the changes in medico-economic indicators between the two groups and analyzed the physical and psychological indicators of the CMG over time. The CMG comprised 51 participants, of which eight dropped out by 12 months after registration. After 1:1 propensity score matching, there were 40 participants in the CMG and CG, respectively. At 12 months after the registration, there was no significant difference between the two groups and no change in the CMG. At 24 months after the registration, the CMG’s medical and long-term care costs decreased significantly, while the CG’s costs increased. Moreover, there was a significant reduction in the number of hospital days and hospital admissions in the CMG. Our findings revealed that nurse-led advanced case management could be useful for patients with complex needs to avoid hospitalization due to exacerbations.

Suggested Citation

  • Kana Kazawa & Michiko Moriyama, 2022. "Community-Based Advanced Case Management for Patients with Complex Multimorbidity and High Medical Dependence: A Longitudinal Study," IJERPH, MDPI, vol. 19(13), pages 1-12, June.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:13:p:7807-:d:847779
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    References listed on IDEAS

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    1. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    2. Vicente Doménech-Briz & Rosario Gómez Romero & Isabel de Miguel-Montoya & Raúl Juárez-Vela & José Ramón Martínez-Riera & María Isabel Mármol-López & María Virtudes Verdeguer-Gómez & Álvaro Sánchez-Rod, 2020. "Results of Nurse Case Management in Primary Heath Care: Bibliographic Review," IJERPH, MDPI, vol. 17(24), pages 1-17, December.
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