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AB1144-HPR Case Management on Frail Patients in the Rheumatology Department at the Regional University Hospital in Malaga
  1. L. Cano-Garcia,
  2. S. Manrique-Arija,
  3. C.M. Romero-Barco,
  4. L. Nieves-Martín,
  5. N. Mena-Vázquez,
  6. M. Rodríguez-Pérez,
  7. M.V. Irigoyen-Óyarzabal,
  8. F.G. Jiménez-Nuñez,
  9. I. Ureña-Garnica,
  10. M.D.C. Ordόñez-Cañizares,
  11. A. Fernández-Nebro
  1. Rheumatology, Hospital Regional Universitario de Málaga, Málaga, Spain

Abstract

Objectives To determine the features of patients referred to case management and from the case management process at the Regional University Hospital in Malaga.

Methods Design: Descriptive cross-sectional study. Patients: patients treated in the Rheumatology service at the Regional University Hospital in Malaga and referred to case management from April to November 2013. The case management model is created as a response to the need for greater efficiency in care management due to the new Socio-medical Syndrome situation caused by the ageing of the population, the increase of frail patients and the need for home care. The case management process begins with the rheumatologist identifying a problem to be referred to case management. The rheumatologist contacts the rheumatology nurse specialist who prepares a report and hands it over to the case management nurse of the hospital. The case management nurse of the hospital contacts the primary care center of the patient that manages the petition from the Rheumatology unit.

Variables include the basic characteristics of the patients, the Barthel index that measures the dependence in activities of daily living, the main reasons for referral to case management and professionals involved in primary care.

Statistical Analysis: Basic descriptive of the results, the Kolmogorov-Smirnov test for the normality of the variables.

Results From April to November 2013, 16 patients (75% women) with an average age 66.5±13.35 years were referred to case management.

Rheumatic diseases in patients were: rheumatoid arthritis (n=10), systemic lupus erythematosus (n=3), scleroderma (n=1), severe osteoporosis (n=1) and psoriatic arthritis (n=1). 87.5% Frail patients with a Barthel index score of severe dependence in 62.5% of cases and of total dependence in 25% of cases. 43.8% lived with relatives, 25% with a professional caregiver and 25% lived alone.

The reasons for referral to case management were: domiciliary nursing (50%), professional in-home caregiving (37.5%), help from the primary care center (PCC) staff (25%), information from the primary care physician (PCP) (25%), social problems (18.8%), nursing-home PCP (6.3%). Primary care professionals involved in the care of these patients were: nurses (62.5%), PCPs (37.5%), social workers (50%), community case manager nurses (50%). In 75% of cases the PCC belonged to the districts of Malaga.

Conclusions Case management is a management tool that integrates primary care and specialty care professionals optimizing resources and improving the quality of health care provided to patients in situations of dependency.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.4555

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