title: Can small intensive case management teams be as effective as large teams?
abstract: In 2007, the Veterans Health Administration (VHA) implemented a program to deliver the full array of Assertive Community Treatment services in areas with low population density using teams with small staffs. VHA administrative data were used to compare treatment and outcomes of veterans who received services from teams with only two or three staff (N=805) and veterans served by teams with ten or more staff (N=861). After adjusting for baseline difference, smaller teams had statistically significantly less symptom improvement and smaller declines in suicidality indices but effect sizes were small and there were no differences on 11 other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small teams.
authors.affiliation: New England Mental Illness, Research, Education and Clinical Center, West Haven, CT, USA, Somaia.Mohamed@yale.edu.
authors.forename: Somaia
authors.initials: S
authors.lastname: Mohamed
mesh_terms: D019090:Case Management; D003155:Community Mental Health Centers; D003158:Community Psychiatry / Q000379:methods*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008507:Medically Underserved Area; D001523:Mental Disorders / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D019035:Rural Health Services; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data