Community-based case management for uninsured patients with chronic diseases

Alison Glendenning-Napoli, Beverly Dowling, John Pulvino, Gwen Baillargeon, Ben G. Raimer

Research output: Contribution to journalArticle

8 Scopus citations

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 1 2012

Keywords

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

ASJC Scopus subject areas

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

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