TY - JOUR
T1 - Flexible client-driven in-home case management
T2 - An option to consider
AU - McWilliam, Carol L.
AU - Stewart, Moira
AU - Vingilis, Evelyn
AU - Hoch, Jeffrey S
AU - Ward-Griffin, Catherine
AU - Donner, Allan
AU - Browne, Gina
AU - Coyte, Peter
AU - Anderson, Karen
PY - 2005/6
Y1 - 2005/6
N2 - Changes in health services and care needs have created high demand for case management of in-home services. To address this challenge, several models of case management have been used. Evaluations to date suggest that clients need different approaches for different circumstances at different times to optimize cost-effectiveness. Accordingly, one Canadian home care program adopted flexible client-driven case management, engaging clients as partners in flexibly selecting either an integrated team, consumer-managed or brokerage model of case management in keeping with their preferences and abilities. Using an exploratory, multimeasure quasi-experimental design, a generic model of program evaluation, and both quantitative and qualitative methods, researchers identified challenges in implementing this intervention, policy impediments the clients characteristically in each of the three case management models, and client, provider, and caregiver outcomes of flexible, client-driven care. While further longitudinal investigation is needed, findings suggest several important considerations for those interested in this option for care management. Alternative case management models do attract different client groups, and having a choice does not alter care costs or outcomes. Flexible client-driven case management may be experienced positively by case managers and other providers.
AB - Changes in health services and care needs have created high demand for case management of in-home services. To address this challenge, several models of case management have been used. Evaluations to date suggest that clients need different approaches for different circumstances at different times to optimize cost-effectiveness. Accordingly, one Canadian home care program adopted flexible client-driven case management, engaging clients as partners in flexibly selecting either an integrated team, consumer-managed or brokerage model of case management in keeping with their preferences and abilities. Using an exploratory, multimeasure quasi-experimental design, a generic model of program evaluation, and both quantitative and qualitative methods, researchers identified challenges in implementing this intervention, policy impediments the clients characteristically in each of the three case management models, and client, provider, and caregiver outcomes of flexible, client-driven care. While further longitudinal investigation is needed, findings suggest several important considerations for those interested in this option for care management. Alternative case management models do attract different client groups, and having a choice does not alter care costs or outcomes. Flexible client-driven case management may be experienced positively by case managers and other providers.
KW - Case management models
KW - Home care delivery
KW - Service approaches
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U2 - 10.1891/cmaj.5.2.73.66281
DO - 10.1891/cmaj.5.2.73.66281
M3 - Article
C2 - 16047912
AN - SCOPUS:20744444747
VL - 5
SP - 73
EP - 86
JO - The Journal of long term home health care : The PRIDE Institute journal
JF - The Journal of long term home health care : The PRIDE Institute journal
SN - 1521-0987
IS - 2
ER -