Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
J Health Serv Res Policy. 2010 Jan;15(1):47-55. doi: 10.1258/jhsrp.2009.008157.
To review the literature on individual community professionals' caseload management (behaviours related to assessment, treatment and discharging of clients) to identify the main themes and concepts, and to synthesize the findings to inform practice, policy and research.
Publications were systematically identified from electronic databases, hand searches of bibliographies, and contact with professional organizations. There were no restrictions on language, the nature of publications or publication year. Procedures were systematically applied for quality appraisal and data extraction. Qualitative and descriptive quantitative methods were used for data analysis and synthesis.
Search criteria yielded 2048 papers of which 42 papers met the inclusion criteria. Thirty-five percent of these were based on research, the rest on professionals' experiences. The papers covered 16 professional and 20 client populations, and their quality was generally poor. Analysis identified six broad themes: definitions of caseload management, caseload measurement and 'tools', models of caseload management practice, client-professional relationship, discharging and professional guidance. Six papers presented issues that related to but did not fit within these themes. Current caseload management tools and models of caseload management practice had a poor evidence base. Five papers described benefits of team-based approaches. Professional guidance for caseload management is limited in detail and relevance to daily practice.
Although there is a considerable literature on caseload management, it is not possible to make summative conclusions. Policy-makers and professional bodies should encourage and support development of research evidence about the ways to achieve effective, efficient and equitable caseload management. Health and social care services considering implementing caseload management tools or models of practice should critically appraise their basis, and consider their potential advantages as well as disadvantages.
回顾关于个体社区专业人员病例管理（与评估、治疗和客户出院相关的行为）的文献，以确定主要主题和概念，并综合研究结果以指导实践、政策和研究。
系统地从电子数据库、文献目录的手工检索以及与专业组织的联系中确定出版物。对语言、出版物的性质或出版年份没有限制。系统地应用程序进行质量评估和数据提取。定性和描述性定量方法用于数据分析和综合。
搜索标准产生了 2048 篇论文，其中 42 篇符合纳入标准。其中 35%的论文基于研究，其余的则基于专业人员的经验。这些论文涵盖了 16 个专业和 20 个客户群体，其质量普遍较差。分析确定了六个广泛的主题：病例管理的定义、病例管理测量和“工具”、病例管理实践模型、客户-专业人员关系、出院和专业指导。有六篇论文提出了与这些主题相关但不适合这些主题的问题。当前的病例管理工具和病例管理实践模型的证据基础较差。五篇论文描述了基于团队方法的好处。病例管理的专业指导在细节和与日常实践的相关性方面都很有限。
尽管有相当多的文献研究病例管理，但无法做出总结性结论。政策制定者和专业机构应鼓励和支持开发有关实现有效、高效和公平的病例管理方法的研究证据。考虑实施病例管理工具或实践模型的卫生和社会保健服务机构应批判性地评估其基础，并考虑其潜在的优势和劣势。
