Internal vs. external care management in severe mental illness: randomized controlled trial and qualitative study.
Background: Case management is the encompassing model for managing people with severe mental illness, but models of case management vary.Aims: To compare the effectiveness of an integrated (internal) model of care management (in which the social worker is a member of the multidisciplinary healthcare...
| Publicado en: | Journal of Mental Health Vol. 13; no. 5; pp. 453 - 467 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Taylor & Francis Ltd
Oct2004
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106571289&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106571289 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09638237 JHM jtl: Journal of Mental Health issn: 09638237 maglogo: N pubinfo: dt: Oct2004 vid: 13 iid: 5 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 106571289 106571289 2005026848 10.1080/09638230400006759 106571289 ppf: 453 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Internal vs. external care management in severe mental illness: randomized controlled trial and qualitative study. aug: au: Rutter D Tyrer P Emmanuel J Weaver T Byford S Hallam A Simmonds S Ferguson B affil: Department of Psychological Medicine, Imperial College London, St. Dunstan's Road, London W6 8RP, UK sug: subj: Case Management Methods Community Mental Health Services Mental Disorders, Chronic Multidisciplinary Care Team Social Work Analysis of Variance Attitude Measures Case Managers Case Studies Clinical Assessment Tools Randomized Controlled Trials Costs and Cost Analysis Descriptive Statistics Funding Source Hospitalization Job Satisfaction Length of Stay Nonparametric Statistics Psychological Tests Qualitative Studies Random Assignment Semi-Structured Interview Social Worker Attitudes T-Tests Treatment Outcomes United Kingdom Validity Human ab: Background: Case management is the encompassing model for managing people with severe mental illness, but models of case management vary.Aims: To compare the effectiveness of an integrated (internal) model of care management (in which the social worker is a member of the multidisciplinary healthcare team) against a brokerage model in which the care manager operates 'externally' to the healthcare team.Method: Patients with severe mental illness meeting a high threshold of need referred to a community team were randomized to a care manager newly appointed to the team, or to a care manager outside the team. Days spent in hospital were the primary outcome measure, and costs for patients in each arm were compared. Semi-structured qualitative interviews were employed to explore a sample of cases in each category; compare joint working practice in both models; and compare practice in London to that within a well-established integrated CMHT in Nottingham.Results: The randomized trial of 'internal' vs. 'external' care management showed no significant differences in outcome or costs among 26 patients. However, the qualitative study revealed worker dissatisfaction with the brokerage model, and identified inefficiencies and duplication of effort.Conclusions: The brokerage model of case management should not be maintained. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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