Community Mental Health Journal

, Volume 35, Issue 2, pp 153–167 | Cite as

Service Components of Case Management Which Reduce Inpatient Care Use for Persons with Serious Mental Illness

  • Eri Kuno
  • Aileen B. Rothbard
  • Roberta G. Sands

Abstract

This is a study of two types of case management:case management (CM) which provided the servicecoordination functions, and Intensive Case Management(ICM) which consisted of both the coordination function and the provision of direct support to theclient. Using secondary data on public clients,characteristics of mental health service use wereanalyzed for 80 ICM and 84 CM clients. The ICM clientshad significantly fewer episodes per patient and less inpatientdays per year than the CM clients. These findingssuggest that direct support services make a significantdifference in reducing annual hospital care.

REFERENCES

  1. Anthony, W. A., Cohen, M., Farkas, M., & Cohen, B. F. (1988). Clinical care update: The chronically mentally ill: Case management—more than a response to a dysfunctional system. Community Mental Health Journal, 24(3), 219–228.Google Scholar
  2. Axelrod, S., & Wetzler, S. (1989). Factors associated with better compliance with psychiatric aftercare. Hospital and Community Psychiatry, 40(4), 397–401.Google Scholar
  3. Bogin, D.C., Anish, S.S., Taub, H.A., and Kline, G.E. (1984). The effects of a referral coordination on compliance with psychiatric discharge plan. Hospital and Community Psychiatry, 35(7), 702–706.Google Scholar
  4. Borland, A., McRae, J., & Lycan, C. (1989). Outcomes of five years of continuous intensive case management. Hospital and community Psychiatry, 40(4), 369–376.Google Scholar
  5. Bond, G. R., Witheridge, T. F., Dincin, J., Wasmer, D., Webb, J., & De Graaf-Kaser, R. (1990). Assertive community treatment for frequent users of psychiatric hospitals in a large city: A controlled study. American Journal of Community Psychology, 18(6), 865–891.Google Scholar
  6. Curtis, J. L., Millman, E, J., Struening, E., & D'Ercole, A. (1992). Effect of case management on rehospitalization and utilization of ambulatory care services. Hospital and Community Psychiatry, 43(9), 895–899.Google Scholar
  7. Deci, P.A., Santos, A.B., Hiott, D.W., Schoenwald, S., & Dias, J.K. (1995). Dissemination of assertive community treatment programs. Psychiatric Services, 46(7), 676–668.Google Scholar
  8. Dincin, J., Wasmer, D., Witheridge, T. F., Sobeck, L., Cook, J., & Razzano, L. (1993). Impact of assertive community treatment on the use of state hospital inpatient bed-days. Hospital and Community Psychiatry, 44(9), 833–838.Google Scholar
  9. Franklin, J. L., Solovitz, B., Mason, M., Clemons, J. R., & Miller, G. E. (1987). An evaluation of case management. American Journal of Public Health, 77(6), 674–678.Google Scholar
  10. Goering, P. N., Wasylenki, D. A., Farkas, M., Lancee, W. J., & Ballantyne, R. (1988). What difference does case management make? Hospital and Community Psychiatry, 39(3), 272–276.Google Scholar
  11. Goldman, H.H., Gattozzi, A.A., & Taube, C.A. (1981). Defining and counting the chronically mentally ill. Hospital and Community Psychiatry, 32(1), 21–27.Google Scholar
  12. Kanter, J. (1989). Clinical case management: Definition, principles, components. Hospital and Community Psychiatry, 40(4), 361–368.Google Scholar
  13. Macias, C., Kinney, R., Farley, O. W., Jackson, R., & Vos, B. (1994). The role of case management within a community support system: Partnership with psychosocial rehabilitation. Community Mental Health Journal, 30(4), 323–339.Google Scholar
  14. McGrew, J.H., Bond, G.R., Dietzen, L., & Salyers, M. (1994). Measuring the fidelity of implementation of a mental health program model. Journal of Consultation and Clinical Psychology, 62(4), 670–678.Google Scholar
  15. Philadelphia Office of Mental Health and Mental Retardation (1990). Annual Update; 1990–1992. Philadelphia: Author.Google Scholar
  16. Philadelphia Office of Mental Health and Mental Retardation (1992). Diversion Services Directory. Philadelphia: Author.Google Scholar
  17. Quinlivan, R., Hough, R., Crowell, A., Beach, C., Hofster, R., & Kenworthy, K. (1995). Service utilization and costs of care for severely mentally ill clients in an intensive case management program. Psychiatric Services, 46(4), 365–371.Google Scholar
  18. Rothbard, A.B., Richman, E., & Hadley, T.R. (in press). “Unbundling” of state hospital services in the community: The Philadelphia state hospital story. Administration and Policy in Mental Health.Google Scholar
  19. Rothbard, A.B., Schinnar, A.P., Hadley, T.R., & Rovi, J.I. (1990). Integration of mental health data on hospital and community services. Administration and Policy in Mental Health, 18(2), 91–99.Google Scholar
  20. Sands, R. G., & Cnaan, R. A. (1994). Two modes of case management: Assessing their impact. Community Mental Health Journal, 30(5), 441–457.Google Scholar
  21. Solomon, P. (1992). The efficacy of case management services for severely mentally disabled clients. Community Mental Health Journal, 28(3), 163–180.Google Scholar
  22. Solomon, P.L., Gordon, B.H., & Davis, J.M. (1984). Community services to discharged psychiatric patients. Springfield, IL: Charles C. Thomas.Google Scholar
  23. Stein, L. I., & Test, M. A. (1980). Alternative to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation. Archives General Psychiatry, 37, 392–397.Google Scholar
  24. Stein, L. I., Diamond, R. J. (1985). A program for difficult-to-treat patients. In L. I. Stein & M. A. Test (Eds.), The training in community living model: A decade of experience: New directions for mental health services No. 26 (pp. 29–39). San Francisco: Jossey-Bass.Google Scholar
  25. Sytema, S., Micciolo, R., & Tansella, M. (1996). Service utilization by schizophrenic patients in Groningen and South-Verona: an event-history analysis. Psychological Medicine, 26, 109–119.Google Scholar
  26. Tessler, R.C., Willis, G., & Gubman, G.D. (1986). Defining and measuring continuity of care. Psychosocial Rehabilitation Journal, 10(1), 27–36.Google Scholar
  27. Test, M. A., Knoedler, W. H., & Allness, D. J. (1985). The long-term treatment of young schizophrenics in a community support program. In L. I. Stein & M. A. Test (Eds.), The training in community living model: A decade of experience: New directions for mental health services No. 26 (pp. 17–27). San Francisco: Jossey-Bass.Google Scholar
  28. Witheridge, T. F. (1989). The assertive community treatment worker: An emerging role and its implications for professional training. Hospital and Community Psychiatry, 40(6), 620–624.Google Scholar

Copyright information

© Human Sciences Press, Inc. 1999

Authors and Affiliations

  • Eri Kuno
  • Aileen B. Rothbard
  • Roberta G. Sands

There are no affiliations available

Personalised recommendations