inav - Institute for Applied Health Services Research, Schiffbauerdamm 12, 10117 Berlin, Germany. Email:
Am J Manag Care. 2022 Jul 1;28(7):e271-e279. doi: 10.37765/ajmc.2022.89186.
In this time of aging and increasingly multimorbid populations, effective and efficient case management approaches play a crucial role in supporting patients who are navigating complex health care systems. Until now, no rigorous systematic review has synthesized studies about the cost-effectiveness of case management.
A systematic review was performed.
The bibliographic databases PubMed and CINAHL Plus were systematically searched using key blocks and synonyms of the terms case management, effectiveness, and costs. The methodological quality of the studies was assessed using the Consensus Health Economic Criteria list.
A total of 29 studies were included. In 3 studies, the intervention was less effective and more costly than the control group and can therefore be considered not cost-effective. Two studies found that the intervention was less effective and less costly. A more effective and less costly intervention, and therefore a strong recommendation for case management, was found in 6 studies. In 17 studies, the intervention was more effective while being more costly. Nearly half of the studies met most of the quality criteria, with 16 or more points out of 19.
Existing studies often have adequate quality and, in many cases, show cost-effective or even cost-saving results. Case management appears to be a promising method to support patients facing complex care situations. However, variation among case management approaches is very high, and the topic needs further study to determine the most cost-effective way of providing such care coordination.
在人口老龄化和日益多病共存的时代，有效的病例管理方法对于支持患者在复杂的医疗保健系统中进行导航起着至关重要的作用。到目前为止，还没有严格的系统评价综合研究病例管理的成本效益。
进行了系统评价。
使用病例管理、效果和成本等术语的关键块和同义词，系统地搜索了 PubMed 和 CINAHL Plus 书目数据库。使用共识健康经济标准清单评估研究的方法学质量。
共纳入 29 项研究。在 3 项研究中，干预措施比对照组效果差且成本更高，因此被认为没有成本效益。有 2 项研究发现干预措施效果较差但成本较低。有 6 项研究发现更有效的且成本更低的干预措施，因此强烈推荐病例管理。在 17 项研究中，干预措施更有效，但成本更高。几乎一半的研究满足了大多数质量标准，19 个标准中有 16 个或更多。
现有研究通常具有足够的质量，并且在许多情况下，显示出成本效益甚至节省成本的结果。病例管理似乎是支持面临复杂护理情况的患者的一种有前途的方法。然而，病例管理方法之间的差异非常大，该主题需要进一步研究，以确定提供这种护理协调的最具成本效益的方法。
