BMJ  2007;334:109 (20 January), doi:10.1136/bmj.39094.396123.1F

Letters

Case management

Government should have respected evidence

The first 150 words of the full text of this article appear below.

Gravelle et al report the impact of case management (Evercare) on frail elderly patients.¹ The Evercare pilot study was based on the findings of one quasi-experimental study of case management in US nursing homes, albeit one with impressive results. It was imported to the United Kingdom in 10 pilot sites and applied to a very different group of patients (community dwelling), in a very different health economy, with different nursing skills and information system. Even the author of the original paper expressed surprise that the intervention had been implemented in this way.² This cost the UK taxpayer over £4m (6m; $7.8m)—not to mention the cost of "backfill" for community nursing posts vacated by the new advanced practitioner nurses. If the Department of Health had any regard for evidence it would not have ignored two excellent systematic reviews^{3 4} that showed no consistent evidence for the effectiveness of case management in . . . [Full text of this article]

¹ Institute of Health Sciences, University of Reading, Reading RG1 5AQ d.oliver@reading.ac.uk

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Relevant Article

Impact of case management (Evercare) on frail elderly patients: controlled before and after analysis of quantitative outcome data

Hugh Gravelle, Mark Dusheiko, Rod Sheaff, Penny Sargent, Ruth Boaden, Susan Pickard, Stuart Parker, and Martin Roland
BMJ 2007 334: 31. [Abstract] [Full Text] [PDF]