Iliffe Steve, Wilcock Jane, Synek Michal, Carboch Radek, Hradcová Dana, Holmerová Iva
Research Department of Primary Care & Population Health, University College London, UK.
Centre of Expertise in Longevity and Long-term Care, Faculty of Humanities, Charles University in Prague, Czech Republic; Department of Sociology, Faculty of Social Studies, Masaryk University, Czech Republic.
Dementia (London). 2019 Apr;18(3):951-969. doi: 10.1177/1471301217697802. Epub 2017 Mar 17.
Case management is generally seen as a way to provide efficient, cost-saving person-centred care for people with dementia by connecting together fragmented services, but the available evidence in favour of its merits is often considered inconclusive, unclear and sketchy. This discussion paper investigates the evidence of the benefit of case management for people with dementia and explores the complexity of the concept and the experiences of its implementation. It offers a comprehensive framework for conceptualising various types of case management and asks the question: who can be a case manager? Building on examples from three European countries it addresses the problem of the expansion and adoption of the case management method. It compares the conventional model of diffusion of innovation with the ideas of interessement and co-constitution and envisions a successful model of case management as a fluid technology that is both friendly and flexible, allowing it to adapt to different settings and systems.
病例管理通常被视为一种通过整合分散的服务，为痴呆症患者提供高效、节省成本的以人为本的护理方式，但支持其优点的现有证据往往被认为是不确定、不明确和粗略的。本讨论文件调查了病例管理对痴呆症患者有益的证据，并探讨了该概念的复杂性及其实施经验。它提供了一个全面的框架，用于对各种类型的病例管理进行概念化，并提出了一个问题：谁可以成为病例管理者？基于三个欧洲国家的例子，它解决了病例管理方法的扩展和采用问题。它将传统的创新扩散模型与利益关联和共同构成的理念进行了比较，并设想了一个成功的病例管理模型，即一种既友好又灵活的流动技术，使其能够适应不同的环境和系统。
