Community-based case management for uninsured patients with chronic diseases

Alison Glendenning-Napoli, Beverly Dowling, John Pulvino, Gwen Baillargeon, Benny Raimer

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Purpose of the Study: To examine the effects of a community-based case management program on acute health care utilization and associated costs in uninsured patients with 1 or more chronic diseases. Primary Practice Setting: Large regional academic medical center that provides health care services for the vast majority of indigent patients in the area. Methodology and Sample: This was a retrospective study of 83 patients who enrolled in a case management program between April 2007 and August 2008 on the basis of 1 or more emergency department visits or acute hospitalizations. Paired t tests were used to compare utilization and costs before and after enrollment. Results: Overall, acute outpatient encounters decreased by 62% and inpatient admissions by 53%, whereas primary care visits increased by 162%. Participation in the case management program was also associated with a 41% reduction in overall aggregate costs, from $16,208 preintervention to $9,541 postintervention ( p = .004). Implications for Case management Practice: The results of this study suggest that intensive case management can reduce acute care utilization and costs and increase primary care follow-up among uninsured patients with certain chronic diseases.

    Original languageEnglish (US)
    Pages (from-to)267-275
    Number of pages9
    JournalProfessional Case Management
    Volume17
    Issue number6
    DOIs
    StatePublished - Nov 2012

    Fingerprint

    Case Management
    Chronic Disease
    Costs and Cost Analysis
    Primary Health Care
    Patient Acceptance of Health Care
    Poverty
    Health Services
    Hospital Emergency Service
    Inpatients
    Hospitalization
    Outpatients
    Retrospective Studies
    Delivery of Health Care

    Keywords

    • Case management
    • Chronic diseases
    • Emergency care
    • Medical indigency
    • Primary health care

    ASJC Scopus subject areas

    • Health Policy
    • Assessment and Diagnosis
    • Care Planning
    • Leadership and Management

    Cite this

    Community-based case management for uninsured patients with chronic diseases. / Glendenning-Napoli, Alison; Dowling, Beverly; Pulvino, John; Baillargeon, Gwen; Raimer, Benny.

    In: Professional Case Management, Vol. 17, No. 6, 11.2012, p. 267-275.

    Research output: Contribution to journalArticle

    Glendenning-Napoli, Alison ; Dowling, Beverly ; Pulvino, John ; Baillargeon, Gwen ; Raimer, Benny. / Community-based case management for uninsured patients with chronic diseases. In: Professional Case Management. 2012 ; Vol. 17, No. 6. pp. 267-275.
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