Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
BMC Health Serv Res. 2012 Jun 18;12:163. doi: 10.1186/1472-6963-12-163.
Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands.
A modified version of the RAND®/University of California at Los Angeles (UCLA) appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round.
Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager.
Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent.
病例管理是一种多样化的护理概念，包括评估、规划、实施、协调、监测和评估满足客户健康和服务需求所需的选项和服务。本文描述了一个专家小组程序的结果，该程序旨在深入了解荷兰姑息治疗中病例管理的目标和特征。
使用改良版的 RAND®/加利福尼亚大学洛杉矶分校（UCLA）适宜性方法来制定和评估姑息治疗中病例管理的目标和特征清单。共有 76 名医疗保健专业人员、研究人员和政策制定者受邀加入专家小组，其中 61%的人至少参加了一轮。
病例管理的九个目标中有十个得到了一致同意。病例管理特征方面最具争议的领域是病例经理的实际护理、病例管理的目标群体、除病例管理以外的其他任务的执行情况以及病例经理的可及性。
尽管目标得到了一致认可，但姑息治疗中的病例管理在实施选择方面存在高度的可变性。病例管理应旨在保持护理的连续性，以确保患者及其亲近的人感受到个性化、连贯和一致的护理。
