title: "Because somebody cared about me. That's how it changed things": homeless, chronically ill patients' perspectives on case management.
abstract: BACKGROUND
  Case management programs for chronically ill, homeless people improve health and resource utilization by linking patients with case managers focused on improving management of medical and psychosocial problems. Little is known about participants' perspectives on case management interventions.
  
  
  METHODS
  This qualitative study used in-depth, one-on-one interviews to understand the impact of a case management program from the perspective of participants. A standardized interview guide with open-ended questions explored experiences with the case management program and feelings about readiness to leave the program.
  
  
  RESULTS
  FOUR RECURRENT THEMES EMERGED: (1) Participants described profound social isolation prior to case management program enrollment; (2) Participants perceived that caring personal relationships with case managers were key to the program; (3) Participants valued assistance with navigating medical and social systems; and (4) Participants perceived that their health improved through both the interpersonal and the practical aspects of case management.
  
  
  CONCLUSIONS
  Chronically ill, homeless people enrolled in a case management program perceived that social support from case managers resulted in improved health. Programs for this population should consider explicitly including comprehensive social support interventions. Further research on case management should explore the impact of different types of social support on outcomes for homeless chronically ill patients.
authors.affiliation: University of California San Francisco, Division of General Internal Medicine, San Francisco General Hospital, United States of America. elizabeth.davis@ucsf.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Davis
authors.forename: Aracely
authors.initials: A
authors.lastname: Tamayo
authors.forename: Alicia
authors.initials: A
authors.lastname: Fernandez
mesh_terms: D019090:Case Management; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D012934:Social Isolation / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires