Abstract

Session presented on: Friday, July 26, 2013:

Purpose: In the UK, 15 million people have at least one long-term condition and represent 70% of the healthcare expenditure. Evidence suggests that improved management of long-term conditions can reduce care costs. Case Management, by Community Matrons, was established using a predictive risk tool to predict the likelihood of an acute admission within the following six months. Potential patients are sent a letter offering an assessment before being admitted to the Virtual Community Ward. Some patients decline the service or find this approach unusual. This study aimed to explore the reactions of patients who have been selected by a computerised risk tool for case management.

Methods: A qualitative study was considered appropriate to answer the research question. A purposive selection of eight patients, newly admitted to the Community Matron's caseload, was interviewed and an interpretative phenomenological analytical model was used to interpret the data.

Results: Four themes emerged from the data: surveillance of health; dimensions of trust; dimensions of health guidance and dynamic perception of ill health. Patients were not particularly concerned about the use of predictive modelling, in many cases it was perceived as the promotion of engagement in health care and intuitive to their health belief systems. A linear model of reactions was thus developed from these findings.

Conclusion: The findings suggest that to gain a true sense of reaction to the use of risk tools further research is required, specifically targeting those who have refused case management, yet could potentially benefit from it the most. Such a care approach will become particularly important, as risk tools become more widely used and hard to reach individuals are required to engage in pro-active case management to prevent the rising cost of chronic ill health.

Author Details

Belinda J. Wigmore, RN, MSc; Sylvie Marshall-Lucette, PhD, MSc, RN, RNT

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

Qualitative Research

Keywords:

Predictive Risk Tool, Case Management, Community Matron

Conference Name

24th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Prague, Czech Republic

Conference Year

2013

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Acquisition

Proxy-submission

Share

COinS
 

Patients' reactions to being selected by a computerised risk tool for case management by a community matron in the UK

Prague, Czech Republic

Session presented on: Friday, July 26, 2013:

Purpose: In the UK, 15 million people have at least one long-term condition and represent 70% of the healthcare expenditure. Evidence suggests that improved management of long-term conditions can reduce care costs. Case Management, by Community Matrons, was established using a predictive risk tool to predict the likelihood of an acute admission within the following six months. Potential patients are sent a letter offering an assessment before being admitted to the Virtual Community Ward. Some patients decline the service or find this approach unusual. This study aimed to explore the reactions of patients who have been selected by a computerised risk tool for case management.

Methods: A qualitative study was considered appropriate to answer the research question. A purposive selection of eight patients, newly admitted to the Community Matron's caseload, was interviewed and an interpretative phenomenological analytical model was used to interpret the data.

Results: Four themes emerged from the data: surveillance of health; dimensions of trust; dimensions of health guidance and dynamic perception of ill health. Patients were not particularly concerned about the use of predictive modelling, in many cases it was perceived as the promotion of engagement in health care and intuitive to their health belief systems. A linear model of reactions was thus developed from these findings.

Conclusion: The findings suggest that to gain a true sense of reaction to the use of risk tools further research is required, specifically targeting those who have refused case management, yet could potentially benefit from it the most. Such a care approach will become particularly important, as risk tools become more widely used and hard to reach individuals are required to engage in pro-active case management to prevent the rising cost of chronic ill health.