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Case Management lo6.1

Ethical Issues in Case Management

3. Respect for the client's rights to be informed about his or her care and services and to choose to receive services or not.

4. Clients have the right to know what resources are available to them and have the right to select providers of the resources.

1. Right to privacy. Confidentiality of clients served must be maintained.

2. Health care resources are expensive and limited.

Disease-Specific Case Management

Case management services are often provided for individ- uals who are identified as having medical conditions that are high-cost or high-volume acute and chronic illnesses. Examples are chronic obstructive pulmonary disease and chronic cardiac conditions such as congestive heart failure. The goal of disease-specific case management is to keep the individuals as healthy as possible and stable in their home environments. One particular goal is to decrease the fre- quency and length of hospital stays and consequently reduce health care costs.

إدارة الحالات الخاصة بالأمراض غالبًا ما يتم تقديم خدمات إدارة الحالة للأفراد الذين تم تحديدهم على أنهم يعانون من حالات طبية عالية التكلفة أو أمراض مزمنة حادة ومزمنة. ومن الأمثلة على ذلك مرض الانسداد الرئوي المزمن وحالات القلب المزمنة مثل قصور القلب الاحتقاني. الهدف من إدارة الحالات الخاصة بمرض معين هو الحفاظ على صحة الأفراد واستقرارهم قدر الإمكان في بيئاتهم المنزلية. أحد الأهداف الخاصة هو تقليل تكرار وطول مدة الإقامة في المستشفى وبالتالي تقليل تكاليف الرعاية الصحية.

Collateral contacts and case management (الاتصالات الجانبية وإدارة الحالة)

3. Family members may also be involved in all components of case management

2. Contacts with others can be either face to face or via phone

1. Case management may include contacts with collateral individuals or family members when necessary to manage the care of the client,to help access services, identify needs and supports, and provide useful feedback to case managers

Goal of all Types of CM

Greater independence on the part of individuals and families in accessing and linking to appropriate services and supports. CM always focus on working themselves out of a job with each individual on their caseload. CM always looking for other less formal supports, family, social services, etc. that will replace the health system.

POSSIBLE CASE MANAGEMENT FUNCTIONS

* Identifying the target population * Determining screening and eligibility * Arranging services * Monitoring and follow-up * Assessing * Planning care * Reassessing * Assisting clients through a complex, fragmented health care system * Care coordination and continuity

Community-Based Case Management

1. Usually high need for assistance with multiple systems 2. Individual has few supports 3.Often significant functional problems social and cognitive deficits that make linking difficult 4. Often need for both community-based work and aggressive outreach along with phone work for coordination of care

Purpose of Case Management

Case management is client centered and system centered. Client-centered case management helps the client or patient proceed through a complex, fragmented, and often › confusing health care delivery system and achieves specific client-centered goals. System-centered case management recognizes that health care resources are finite.

The purpose of this guide is to provide a resource for every case manager in engaging patients in active participation in: • Patient knowledge • Patient involvement in care • Patient empowerment •Improved adherence • Improved coordination of care

what is Case Management

An Activity which assists individuals in gaining and coordinating access to necessary care and services appropriate to the needs of an individual.

is a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.”