Kuhn Ulrike, Düsterdiek Anne, Galushko Maren, Dose Christina, Montag Thomas, Ostgathe Christoph, Voltz Raymond
Department of Palliative Medicine, University Hospital Cologne, Cologne, Germany.
BMC Res Notes. 2012 Nov 1;5:611. doi: 10.1186/1756-0500-5-611.
In Germany, case management in a palliative care unit was first implemented in 2005 at the Department of Palliative Medicine at the University Hospital Cologne. One of the purposes of this case management is to deal with enquiries from patients and their relatives as well as medical professionals. Using the Case Management Process Model of the Case Management Society of America as a reference, this study analysed (a) how this case management was used by different enquiring groups and (b) how patients were identified for case management and for palliative care services. The first thousand enquiries were analysed considering patient variables, properties of the enquiring persons and the content of the consultations.
Most enquiries to the case management were made by telephone. The majority of requests regarded patients with oncological disease (84.3 %). The largest enquiring group was composed of patients and relatives (40.8 %), followed by internal professionals of the hospital (36.1 %). Most of the enquiring persons asked for a patient's admission to the palliative care ward (46.4 %). The second most frequent request was for consultation and advice (30.9 %), followed by requests for the palliative home care service (13.3 %). Frequent reasons for actual admissions were the need for the treatment of pain, the presence of symptoms and the need for nursing care. More than half of the enquiries concerning admission to the palliative care ward were followed by an admission.
Case management has been made public among the relevant target groups. Case management as described by the Case Management Process Model helps to identify patients likely to benefit from case management and palliative care services. In addition, with the help of case management palliative patients may be allocated to particular health care services.
在德国，2005年科隆大学医院姑息医学科首次在姑息治疗单元实施病例管理。这种病例管理的目的之一是处理患者及其亲属以及医学专业人员的咨询。本研究以美国病例管理协会的病例管理流程模型为参考，分析了（a）不同咨询群体如何使用这种病例管理，以及（b）如何确定适合病例管理和姑息治疗服务的患者。对最初的1000次咨询进行了分析，考虑了患者变量、咨询者的属性以及咨询内容。
向病例管理部门的咨询大多通过电话进行。大多数请求涉及肿瘤疾病患者（84.3%）。最大的咨询群体是患者及其亲属（40.8%），其次是医院内部专业人员（36.1%）。大多数咨询者要求将患者收治到姑息治疗病房（46.4%）。第二常见的请求是咨询和建议（30.9%），其次是请求姑息家庭护理服务（13.3%）。实际收治的常见原因是需要治疗疼痛、存在症状以及需要护理。关于收治到姑息治疗病房的咨询中，超过一半之后会有收治情况。
病例管理已在相关目标群体中公开。病例管理流程模型所描述的病例管理有助于识别可能从病例管理和姑息治疗服务中受益的患者。此外，借助病例管理，姑息患者可能会被分配到特定的医疗服务中。
