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.”
