Clinical Research Study: Telephonic Case Management

The Approach

A randomized controlled clinical trial was used to assess the effect of telephonic case management on patients' use of hospital resources.

Randomly selected patients received six months of either the telephone-based intervention or the usual mode of care. Hospitalization rates, readmission rates, hospital days, days to first rehospitalization, multiple readmissions, emergency department visits, in-patient costs, out-patient resource use, and patient satisfaction were measured at 3 and 6 months.

The Solution

The heart failure hospitalization rate was 45.7% lower in the intervention group at 3 months and 47.8% lower at 6 months. Heart failure hospital days and multiple readmissions were significantly lower in the intervention group at 6 months. In-patient heart failure costs were 45.5% lower at 6 months. A cost savings was realized even after intervention costs were deducted. There was no evidence of cost-shifting to the out-patient setting. Patient satisfaction was higher in the intervention group.

Benefits

The reduction in hospitalizations , costs, and other resource use achieved using standardized telephonic case management in the early months after a heart failure admission is greater than that usually achieved with pharmaceutical therapy and is comparable with other disease management approaches. This study demonstrates that standardized nurse case management provided to a patient by telephone during the early months after a hospital admission can achieve significant cost savings, reductions in resource use, and increases in patient satisfaction.