title: The integration of primary care and case management in chronic disease.
abstract: Case management historically has been facility based and has focused on discharge planning and utilization review. Integrated case management needs to include risk screening, disability prevention programs, linked information processes, and interdisciplinary teams that manage care over time and across settings. This article describes one such model that can change primary care into a process that involves the entire team, including the patient.
authors.affiliation: Sutter/CHS, Sacramento, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Phillips-Harris
mesh_terms: D019090:Case Management / Q000458:organization & administration*; D002908:Chronic Disease; D003266:Continuity of Patient Care / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D010348:Patient Care Team; D010358:Patient Participation; D011320:Primary Health Care / Q000458:organization & administration*; D018570:Risk Assessment; D012648:Self Care; D014481:United States