RESUMO
Using quantitative and qualitative methodology, a study was conducted on the process of case management performed by nurse case managers on a group of 45 post-discharged frail elderly patients in 2001-2002. The quantitative data provided the common reasons for client-initiated telephone calls to nurse case managers and the nurse case managers' interventions to these calls. Qualitative data yielded 9 major themes on which a sequential and dynamic process model of case management was conceptualized. Another 7 thematic descriptions on essential factors for the successful implementation of case management were configured in a dual-dimensional framework of staff and structural factors.
Assuntos
Assistência ao Convalescente/organização & administração , Atitude do Pessoal de Saúde , Administração de Caso/organização & administração , Idoso Fragilizado , Recursos Humanos de Enfermagem/psicologia , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Idoso , Enfermagem em Saúde Comunitária/organização & administração , Grupos Focais , Enfermagem Geriátrica/organização & administração , Hong Kong , Humanos , Estudos Longitudinais , Modelos de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pesquisa Metodológica em Enfermagem , Recursos Humanos de Enfermagem/organização & administração , Alta do Paciente/normas , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Centros de Reabilitação , Inquéritos e Questionários , Telefone , Carga de TrabalhoRESUMO
A 12-month randomised controlled trial was conducted in Hong Kong to evaluate the effectiveness of case management provided to a group of home-dwelling, frail elderly patients (control group: n = 47; intervention group: n = 45) in terms of utilisation of hospital services by these patients. Significant reductions (significance at P = 0.05) in mean total number of hospital bed-days (P < 0.001), mean total episodes of hospital admissions (P < 0.001), and mean total number of attendances at the outpatient department (P < 0.05) were observed when the baseline and post-intervention differences between the intervention and control groups were compared. The study demonstrated that utilisation of hospital services could be significantly reduced when a group of elderly patients and their caregivers received timely interventions and appropriate services through case management services.