More Than a Case Manager
Authors: Edward H. Wagner
Journal: Annals of Internal Medicine (1998)

Editorials15 October 1998More Than a Case ManagerEdward H. Wagner, MD, MPHEdward H. Wagner, MD, MPHGroup Health Cooperative of Puget Sound; Seattle, WA 98101-1448Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Abundant evidence shows that usual medical care does not meet many of the clinical and educational needs of diabetic patients [1, 2]. The reasons for this lackluster performance are the subject of active debate. Don't primary care providers have the expertise and experience to optimize diabetes care, or are they caring for diabetic patients in acute care systems that are ill suited to meet the complex, ongoing needs of patients with chronic illness? Although the need for more expertise plays some role, the evidence suggests that the system effects are even greater [3]. For example, the Medical Outcomes Study showed ...References1. Kenny SJ, Smith PJ, Goldschmid MG, Newman JM, Herman WH. Survey of physician practice behaviors related to diabetes mellitus in the U.S. Physician adherence to consensus recommendations. Diabetes Care. 1993; 16:1507-10. Google Scholar2. Weiner JP, Parente ST, Garnick DW, Fowles J, Lawthers AG, Palmer RH. Variation in office-based quality. A claims-based profile of care provided to Medicare patients with diabetes. JAMA. 1995; 273:1503-8. Google Scholar3. Wagner EH, Austin B, Von Korff M. Improving outcomes in chronic illness. Managed Care Quarterly. 1996; 4:12-25. Google Scholar4. Greenfield S, Rogers W, Mangotich M, Carney MF, Tarlov AR. Outcomes of patients with hypertension and non-insulin dependent diabetes mellitus treated by different systems and specialties. Results from the Medical Outcomes Study. JAMA. 1995; 274:1436-44. Google Scholar5. Nicolucci A, Scorpiglione N, Belfiglio M, Carinici F, Cavaliere D, elShazly M, et al. Patterns of care an Italian diabetic population. The Italian Study Group for the Implementation of the St. Vincent Declaration, Societa Italiana di Diabetologia, Associazione Medici Diabetologi. Diabet Med. 1997; 14:158-66. Google Scholar6. Ho M, Marger M, Beart J, Yip I, Shekelle P. Is the quality of diabetes care better in a diabetes clinic or in a general medicine clinic? Diabetes Care. 1997; 20:472-5. Google Scholar7. The effect of intensive treatment on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993; 329:977-86. Google Scholar8. Aubert RE, Herman WH, Waters J, Moore W, Sutton D, Peterson BL, et al. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization. A randomized, controlled trial. Ann Intern Med. 1998; 129:605-12. Google Scholar9. Peters AL, Davidson MB, Ossorio RL. Management of patients with diabetes by nurses with support of subspecialists. HMO Practice. 1995; 9:8-13. Google Scholar10. DeBusk RF, Miller NH, Superko HR, Dennis CA, Thomas RJ, Lew HT, et al. A case-management system for coronary risk factor modification after acute myocardial infarction. Ann Intern Med. 1994; 120:721-9. Google Scholar11. Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995; 333:1190-5. Google Scholar12. Stuck AE, Aronow HU, Steiner A, Alessi CA, Bula CJ, Gold MN, et al. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med. 1995; 333:1184-9. Google Scholar13. Leveille SG, Wagner EH, Davis C, Grothaus L, Wallace JI, LoGerfo M, et al. Preventing disability and managing chronic illness in frail older adults: A randomized trial of a community-based partnership with primary care. J Am Geriatr Soc. [In press] Google Scholar14. Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG. Telephone care as a substitute for routine clinic follow-up. JAMA. 1992; 267:1788-93. Google Scholar15. Von Korff M, Gruman J, Schaefer J, Curry SJ, Wagner EH. Collaborative management of chronic illness. Ann Intern Med. 1997; 127:1097-102. Google Scholar16. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q. 1996; 74:511-44. Google Scholar17. Vinicor F, Cohen SJ, Mazzuca SA, Moorman N, Wheeler M, Kuebler T, et al. DIABEDS: A randomized trial of the effects of physician and/or patient education on diabetes patient outcomes. J Chronic Dis. 1987; 40:345-56. Google Scholar18. Litzelman DK, Slemenda CW, Langefeld CD, Hays LM, Welch MA, Bild DE, et al. Reduction of lower extremity clinical abnormalities in patients with non–insulin-dependent diabetes mellitus. A randomized, controlled trial. Ann Intern Med. 1993; 119:36-41. Google Scholar19. McCulloch DK, Price MJ, Hindmarsh M, Wagner EH. A population-based approach to diabetes management in a primary care setting: early results and lessons learned. Effective Clinical Practice. 1998; 1:12-22. Google Scholar20. Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Effective Clinical Practice. 1998; 1:2-4. Google Scholar Author, Article, and Disclosure InformationAuthors: Edward H. Wagner, MD, MPHAffiliations: Group Health Cooperative of Puget Sound; Seattle, WA 98101-1448Grant Support: In part by the Robert Wood Johnson Foundation.Corresponding Author: Edward H. Wagner, MD, MPH, Center for Health Studies, 1730 Minor Avenue, Suite 1290, Seattle, WA 98101-1448. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNurse Case Management To Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization Ronald E. Aubert , William H. Herman , Janice Waters , William Moore , David Sutton , Bercedis L. Peterson , Cathy M. Bailey , and Jeffrey P. Koplan Metrics Cited byDevelopment and appropriateness of a scoring method for International Classification of Functioning, Disabilities, and Health assessment in older patients with heart failure: a Delphi survey of expert panel in JapanQualitäts- und KostensteuerungLeistungsmanagementThe International Classification of Functioning, Disabilities, and Health categories rated as necessary for care planning for older patients with heart failure: a survey of care managers in JapanBlended Collaborative Care to Treat Heart Failure and Comorbid Depression: Rationale and Study Design of the Hopeful Heart TrialQuality ManagementLeistungsmanagement'Where to, Doc?' 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Davidson, MDLeistungsmanagement in der Integrierten Versorgung 15 October 1998Volume 129, Issue 8Page: 654-656KeywordsHealth maintenance organizationsHemoglobinMedical educationMedical risk factorsNursesNursing homesPatient advocacyPatientsPopulation statisticsRandomized trials ePublished: 15 August 2000 Issue Published: 15 October 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...