The article “Evidence-based Nurse Case Management Practice in Community Health” seeks to expound further the effectiveness of different types of case management services in improving patient care especially in community-based settings. Case management (CM) is an important and relevant strategy that is practiced in nursing with an aim of reducing the cost of care while at the same time providing quality care to the individual patient. There is a limited number of literature that exists which compare the types or modes of CM with patient outcomes. In fact, no study exists that compares types of CM services offered to patient outcomes in a community-based setting and this is what this study aims to address.
The study was a secondary analysis of precollected data that originated from a part of the Medicare Coordinated Care Demonstration project by the Centers for Medicare and Medicaid Services (CMS). The sample that was used in this study was obtained from a dataset in one of the programs in the CMS study that had been collected from 2002 to 2004. In the dataset, 11 Nurse Care Managers (NCMs) were in charge of 252 Medicare beneficiaries used 4 methods of care services and contact methods. These methods include: high home care services, high clinic care services, high telephone care services and mixed care services. These medicare beneficiaries had multiple chronic diseases, were Caucasian, aged 65 years and over and lived in the Midwest region of the United States. The variables that were looked at in this study were the 4 modes of CM service and responses to the three surveys measuring self-care ADL, quality of life, and personal well-being respectively.
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The results of this study indicated that majority of the NCMs provided high home care and mixed care services to their patients. Their selection was based on expert judgment as well as careful assessment of patient needs. Moreover, there was no statistically significant differences in patient’s clinical qualitative outcomes among all the 4 modes of CM. From this, two inferences can be made either all the four modes of CM have similar effectiveness or the care givers are highly skilled a matching service to patients’ needs. However, the measurements used could not allow for a conclusive inference to be made.
In conclusion, this study gives evidence that Nurse case managers are a vital professional group in the healthcare industry. Moreover, it gives evidence that NCMs’ practice in community-based settings provides coordinated care services while at the same time ensuring positive qualitative outcomes among the patients. In my opinion, I think service mode trends should be incorporated into effective community-based CM practice by using the results of ongoing outcomes measurement and monitoring.
