Published: 25/11/2004, Volume II4, No. 5933 Page 7
Primary care trusts are being warned that case management 'is unlikely to provide an 'off the shelf' solution' for reducing emergency bed days in line with targets.
In a review of research into case management for older people with long-term conditions due to be published on Tuesday, the King's Fund's will say there is only 'weak' evidence that it reduces emergency admissions.
The review also finds limited evidence that case management cuts use of emergency departments or costs, and says the 19 studies examined fail to show that any one model is superior to any other.
In particular, the review says key US studies relate to nursing homes - a very different context to the community approach being promoted in England.
'In the absence of any evidence for any specific model of case management, PCTs should clarify the needs they are trying to address and then consider how to organise services to address those needs, ' it says.
'This may be possible by adapting existing services.' The caution is in marked contrast to the enthusiasm for case management being shown by the Department of Health, which earlier this year was given a public service agreement target to cut the number of emergency bed days by 5 per cent from next year. The DoH is expected to publish its framework on longterm conditions in early December.
Find out more
Case Managing Long-Term Conditions: what impact does it have in the t reatment of older people? will be available f rom 30 November -www. kingsfund. org. uk
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