Case-managing long-term conditions : what impact does it have on the treatment of older people?

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This review examines evidence for the effectiveness of case management for older people. Five outcome measures were considered: hospital admissions, use of emergency departments, length of stay, functional health status and costs. The review concludes that while there is come support in the literature for case management as a method of reducing the use of hospital beds, the evidence is not conclusive. The variety of case management arrangements under investigation makes it hard to generalise results to local NHS settings. The review's recommendations are that: PCTs need to be clear about the needs of the population at whome case management is targeted; local discussion is needed about whether case ,management is best developed by adapting existing services or whether new arrangements should be put in place; case management should be developed in close collaboration with social care providers; PCTs need to ensure that services are in place for people with less severe illness and all case management initiatives should be evaluated. [SMD]

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