Demand management and case management: a conservation strategy.
OBJECTIVE
This article reviews the history and development of managed competition, and explores the possibilities of a new demand management strategy in the context of nurse case management to offer less costly, higher quality care for a greater number of patients.


METHODS
The article examines the history and principles of healthcare demand management, its implementation in the hospital and clinical practices of nurse case managers, and its impacts in reducing costs while maintaining care levels.


CONCLUSIONS
The article develops and analyzes the conflicts and common ground between demand management and case management. First, demand-side strategies can be effective in reducing costs while maintaining quality of nursing care; second, nurse case managers should employ patient education, self-care, and staffing solutions to manage demand.


CONCLUSIONS
Nurse case managers must apply demand management principles carefully. Their goal is not to restrict care, but to maintain the highest levels of care possible within the limits of their practice's resources and staffing. Two critical themes emerge: (1) demand management is a potential alternative to market-driven managed competition and (2) nursing case management can affect an effective form of demand management. However, the long-term implications of these nursing case management strategies on healthcare staffing need further exploration.
Bryant
C D R Anna K
CD
United States Public Health Service, HRSA/BPHC/DHCM/SE Branch, Rockville, MD 20857, USA. akb0605@comcast.net.
D019090:Case Management / Q000458:organization & administration*; D003363:Cost Control; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008389:Marketing of Health Services / Q000458:organization & administration; D016294:Models, Nursing; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration*; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010344:Patient Advocacy; D018802:Patient-Centered Care / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D014481:United States