Erkel E A
Medical University of South Carolina, College of Nursing, Charleston.
J Nurs Adm. 1993 Jan;23(1):27-32.
The success of case management in increasing the use of community-based services among a variety of chronically ill and medically fragile populations and in decreasing the frequency and length of stay of hospitalization is well documented. Less well established is its impact in preventive services and cost effectiveness, and the effect on health outcomes. The author discusses evidence of the effectiveness and cost effectiveness of case management in preventive services and other healthcare contexts. Finally, the author asks an important question, that is, what differentiates the context in which case management is effective from others? The author suggests that nurse case managers are the crucial determinant of successful case management.
病例管理在各类慢性病患者和医疗脆弱人群中增加基于社区服务的使用，以及减少住院频率和住院时长方面的成功已有充分记录。但其在预防服务和成本效益方面的影响，以及对健康结果的影响则不太明确。作者讨论了病例管理在预防服务和其他医疗环境中的有效性和成本效益的证据。最后，作者提出了一个重要问题，即病例管理有效的背景与其他背景有何不同？作者认为护士病例管理者是成功进行病例管理的关键决定因素。
