The authors declare that they have no conflict of interest.
All authors have contributed substantially to this manuscript. The first author (AvdP) participated in the design of the study, carried out the measurements, analysed and interpreted the data and drafted the manuscript. The last author (BO-P) conceived of the study, participated in its design and coordination and made substantial contributions to the data interpretation and writing of the paper. The second author (AF) also made substantial contributions to the data interpretation and writing of the paper. The other authors (WJ, KV and LD) participated in design of the study, interpretation of the data and critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.
Case managers have been introduced in Dutch primary palliative care; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner and home care nurses. This study aims to describe support and investigate what characteristics of patients and the organizational setting are related to the number of contacts and to the number of times topics are discussed between the case manager and patients and/or informal carers.
Prospective study following cancer patients (n = 662) receiving support from a palliative care case manager in Dutch primary care, using registration forms filled out by the case manager after contact with the patient and/or informal carer. In backward linear regression, the association was studied between patient or organizational characteristics and the number of contacts and the number of times conversation topics were discussed.
Organizational characteristics add more to explained variability in data than patient characteristics. Case managers provide support in a flexible manner with regard to the number, mode, persons present, and duration of contacts. Support covered all domains of palliative care, with most attention given to physical complaints, life expectancy and psychological aspects.
Support offered by the case managers is prompted by characteristics of the organization for which they work. This is contradictory to the idea of patient centered care highly valued in palliative care.
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- Case management in primary palliative care is associated more strongly with organisational than with patient characteristics: results from a cross-sectional prospective study
Annicka GM van der Plas
Anneke L Francke
Kris C Vissers
Wim JJ Jansen
Bregje D Onwuteaka-Philipsen
- BioMed Central
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