title: [The effectiveness of continuing care models in patients with chronic diseases: a systematic review].
abstract: BACKGROUND
  Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs.
  
  
  OBJECTIVE
  This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method.
  
  
  METHODS
  Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases).
  
  
  RESULTS
  Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life.
  
  
  CONCLUSIONS
  This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.
authors.affiliation: Department of Nursing, Cheng Ching Hospital, Taiwan, ROC.
authors.forename: Hsiao-Mei
authors.initials: HM
authors.lastname: Chen
authors.affiliation: Department of Nursing, Meiho University, Taiwan, ROC.
authors.forename: Tung-Chen
authors.initials: TC
authors.lastname: Han
authors.affiliation: Department of Nursing, National Cheng Kung University, Taiwan, ROC. chingmin@mail.ncku.edu.tw.
authors.forename: Ching-Min
authors.initials: CM
authors.lastname: Chen
mesh_terms: D019090:Case Management; D002908:Chronic Disease / Q000451:nursing*; D003266:Continuity of Patient Care; D006801:Humans; D010351:Patient Discharge
keywords: case management; chronic disease; continuity of care; discharge planning