Etudes originales

A new profession of health: the case manager

A new profession of health: the case manager

 A study shows the economic efficiency of a case manager in the care of people with chronic respiratory disease.

A randomized controlled Canadian Bourbeau and colleagues published in the journal Chest in 2006 tested the benefits of Living well with COPD program involving a case manager. A case manager individually deals with 50 patients suffering from Chronic Obstructive Pulmonary Disease (COPD). This professional can be contacted by phone and regularly contacts the patient to help him cope with the disease. The study focused on 191 patients presenting. The results show a significant reduction in care for one year. The economy is 1564 euros per year per patient.


The Study Rationale

The Chronic Obstructive Pulmonary Disease (COPD) is the fifth leading cause of death worldwide. This chronic disease affects one million and a half people in France alone. About as many patients are unaware of confusing signs of COPD with a passing bronchitis or wrongly attributing these difficulties to fatigue or aging. The cause of this disease is mainly active smoking and / or liabilities. COPD is currently not curable. Over the COPD diagnosis is delayed, the greater the loss of autonomy are important and irreversible. People with this disease have difficulty to manage daily. Therapeutic education programs are now recommended by scientific societies to help patients better manage everyday. This study examines the cost / effectiveness of these methods, the case manager ratio.

The case manager could be a great way to improve COPD patients to manage their disease.

The Question

A therapeutic education program including a “case manager” it reduces health expenditure in COPD?

The Protocol

The randomized controlled Canadian Bourbeau and colleagues tested the effectiveness of a Living well with COPD therapeutic education program involving a “case manager.” The study focused on 191 patients at least 50 years of age with COPD. The “case manager” was a nurse or therapist experienced in behavioral and psychological management of COPD. He or she will have a complete guide on the management of COPD Living well with COPD. Each patient was receiving a guide with practical exercises to do at home. The “case manager” was based on this guide to provide advice. He personnalisait contextualisait and depending on the patient. He or she was also based on an individual action plan approved by a doctor and made ​​available by telephone. He or she would call at least once a month each patient. The study compares the benefits of case manager after one year of intervention to a control group.

Main Results

The results show a reduction in one year of care demands (consultations, hospitalizations, home visits) in the intervention group compared with the control group. That’s a savings of 1,564 euros on average per year per patient if the manager takes care of 50 patients. Reducing the number of exacerbations (infection, transient worsening) and hospitalizations is certainly a gain in quality of life for patients.

A case manager saves 1,564 euros on average per year per patient COPD.


What it means for Patients

Benefit from a “case manager” greatly helps the management of COPD in daily life.

What it means for Healthcare Professionals

Recruit a “case manager” involved 50 patients as part of patient education in COPD would be a savings of 1,564 euros on average per year per patient.

What it means for Researchers

251 of 469 patients refused to participate because of such evaluations in this study. Non-drug test is expensive, not only in terms of funding.

What it means for Policymakers

Recruit a “case manager” involved 50 patients as part of patient education in COPD would be a savings of 1,564 euros on average per year per patient.


 The reference

Bourbeau J, Collet JP, Schwartzman K, Ducruet T, Nault D, Bradley D, COPD axis of the Respiratory Health Network of the FRSQ (2006). Economic benefits of self-management education in COPDChest, 130, 1704-1711.


To reference this Blog en Sante © article.

Ninot G (2014). A new profession of health: the case manager. Blog en Sante, A21.

© Copyright 2014 Grégory Ninot. All rights reserved.

One thought on “A new profession of health: the case manager
  1. Rodary says:

    Article intéressant, étant gestionnaire de cas (case manager) dans une MAIA je trouve justement que notre fonction n’est pas optimisée pour avoir un impact financier sur le parcours des personnes âgées.

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