title: Palliative care case management in primary care settings: a nationwide survey.
abstract: BACKGROUND
  In case management an individual or small team is responsible for navigating the patient through complex care. Characteristics of case management within and throughout different target groups and settings vary widely. Case management is relatively new in palliative care. Insight into the content of care and organisational characteristics of case management in palliative care is needed.
  
  
  OBJECTIVE
  To investigate how many case management initiatives for palliative care there are in the Netherlands for patients living at home; to describe the characteristics of these initiatives with regard to content and organisation of care.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  A nationwide survey of all 50 coordinators of networks in palliative care in the Netherlands was conducted. Additional respondents were found through snowball sampling. We looked at 33 possible initiatives using interviews (n=33) and questionnaires (n=30).
  
  
  RESULTS
  We identified 20 initiatives for case management. All stated that case management is supplemental to other care. In all initiatives the case managers are registered nurses and most possess higher vocational education and/or further training. All initiatives seek to identify the multidimensional care needs of the patients and the relatives and friends who care for them. Almost all provide information and support and refer patients who need care. Differences are found between the organisations offering the case management, their target groups, the names of the initiatives and whether direct patient care is provided by the case manager.
  
  
  CONCLUSIONS
  In the Netherlands, case management in palliative care is new. Several models of delivery were identified. Research is needed to gain insight into the best way to deliver case management. By describing characteristics of case management in palliative care, an important first step is made in identifying effective elements of case management.
authors.affiliation: Department of Public and Occupational Health, VU University Medical Center, The Netherlands; Center of Expertise in Palliative Care, VU University Medical Center, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, The Netherlands. Electronic address: eol@vumc.nl.
authors.forename: Annicka G M
authors.initials: AG
authors.lastname: van der Plas
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
authors.forename: Marlies
authors.initials: M
authors.lastname: van de Watering
authors.forename: Wim J J
authors.initials: WJ
authors.lastname: Jansen
authors.forename: Kris C
authors.initials: KC
authors.lastname: Vissers
authors.forename: Bregje D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
mesh_terms: D019090:Case Management; D019538:Health Care Surveys; D009426:Netherlands; D010166:Palliative Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*
keywords: Case management; Continuity of patient care; Delivery of health care; End-of-life care; Palliative care