The Journal of the American Board of Family Practice, Vol 12, Issue 4 264-269, Copyright © 1999 by American Board of Family Practice

ARTICLES

Intensive case management of high-risk patients in a family medicine residency setting

S. G. Friedhoff
Family Practice Residency Program, Memorial Hospital of Burlington County, Mount Holly, NJ 08060, USA.

BACKGROUND: As the health care system evolves, health care delivery systems have begun to share risk for the care of patient populations. The prototype for such a system has long been the uncompensated care population in a hospital's service area. This article describes a successful case management pilot program in a family medicine residency setting. METHODS: Nineteen high-risk patients were cared for by a case management team for a period of 3 to 4 months. The case management team consisted of a medical director, 2 resident assistant medical directors, 1 registered nurse case manager, and 1 social worker. RESULTS: Case management resulted in an annualized decrease of 51 percent of inpatient days and 46 percent of charges. This resulted in an annualized savings of $166,083 in charges to the health care system. CONCLUSION: Intensive case management of the sickest of the sick results in a substantial reduction in morbidity and cost. Family medicine residency programs are ideally situated to oversee case management of this population and potentially other populations in a shared-risk environment.

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