Case Management

Excerpt

Case management is defined as a health care process in which a professional helps a patient or client develop a plan that coordinates and integrates the support services that the patient/client needs to optimize the healthcare and psychosocial possible goals and outcomes. The case management process helps the patient and their family navigate through a complicated set of services and supports available within a benefit plan, an organization or institution, and their community. Concerning cost-effective outcome analysis, Hudon et al. found that approximately 10% of patients account for approximately 70% of all healthcare expenditures. Statistics show that 5% of emergency department patients account for 30 to 50% of emergency department visits and these high utilizing patients may unsuccessfully attempt to meet their healthcare and related needs on their own which often is ineffective, characterized by overutilization of expensive, or underutilization and uncoordinated effective health care and social services.