Making a jigsaw puzzle in 10 minutes: is case management feasible in general practice?

摘要

Key messages class="unordered" style="list-style-type:disc">The management of long-term conditions and chronic diseases is the main challenge for primary care worldwide. Individuals with long-term conditions consume a large proportion of health and social care resources, including 60% of hospital bed days in NHS hospitals.The National Health Service has embarked on a chronic disease management programme built around fostering self-management, enhancing disease management in primary care, and introducing case management for individuals with complex problems who make high use of hospital services.Community matrons were appointed to carry out case management tasks for older people at risk of frequent hospital admission, but their impact has been limited.Case management may be being applied too late in the trajectory of disease and disability to achieve its objectives. Applied to a lower risk population of individuals with long-term conditions, it might offer a way for general practitioners and their teams to address the needs of those who have complex problems.