Table 1.

Included studies

Article	CM definition	Objective	Eligibility criteria and included studies
Huntley et al. (2013) (Family Practice) Is case management effective in reducing the risk of unplanned hospital admissions for older people? A systematic review and meta-analysis	A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individualʼs and familyʼs comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.	The aim of this study was to conduct a systematic review of the randomized controlled trial (RCT) evidence for the effectiveness of case management in reducing unplanned hospital admissions for older people.	Inclusion criteria were as follows: RCTs of CM initiated either in or after discharge from acute care hospitals, including the emergency department (ED), or in the community for the older population, in which one of the outcomes was number of unplanned hospital admissions or readmissions; that were either published in English or had an English abstract; and that were carried out in an Organization for Economic Co-operation and Development (OECD) country. This last criterion was chosen so that the results could be broadly applicable to the UK and other similar health systems. 11 RCTs from 1992 to 2011.
Kim and Soeken (2005) (Nursing Research) A meta-analysis of the effect of hospital-based case management on hospital length-of-stay and readmission	Hospital-based CM is defined as a dynamic system of care involving construction of interdisciplinary protocols, continual monitoring, and facilitation of a treatment plan.	The purpose of this study was to investigate the effect of hospital-based CM as compared with usual care on length of hospital stay and readmission rate by using a meta-analytic method. The research question was, ‘Is case management effective in reducing the hospital stay of inpatients and the readmission rate?’	Inclusion criteria were as follows: (a)sample included adults aged 18 years and more; (b)intervention was hospital-based CM for inpatients; (c)the design was randomized experimental; (d)information was provided regarding the difference in length of stay or readmission rate as an outcome measure; (e)the number of participants in the study groups was reported. Studies in which patients were mentally ill or received outpatient services were excluded. Studies implementing hospital-to-community-based or community-based CM were also excluded. 12 studies from 1992 to 2003.
Smith et al. (2016) (Cochrane Database of Systematic Reviews) Interventions for improving outcomes in patients with multimorbidity in primary care and community settings	The explicit allocation of tasks coordination to an appointed individual or group, postulating that the function of coordination is so important and specialized that responsibility for carrying it out needs to be explicitly allocated.	To determine the effectiveness of health-service or patient-oriented interventions designed to improve outcomes in people with multimorbidity in primary care and community settings. Multimorbidity was defined as two or more chronic conditions in the same individual.	The review included studies where CM was employed but only if it was specifically directed towards individuals identified as having multimorbidity. It included any type of intervention that was specifically directed towards a group of people defined as having multimorbidity. Only interventions based in primary care and community settings were included. Interventions included care delivered by family doctors, nurses, or other primary care professionals. Studies where multimorbidity was assumed to be the norm on the basis of individuals’ age were excluded as the interventions were not being targeted specifically at multimorbidity and its recognized challenges. This included studies where interventions were directed at communities of people based on location or age of participants in which participants could be presumed to have multimorbidity on the basis of their age or residence in a nursing home, but interventions were not designed to specifically target multimorbidity. The authors identified 18 RCTs (from 1999 to 2015) examining a range of complex interventions for people with multimorbidity. Nine studies focused on defined comorbid conditions with an emphasis on depression, diabetes, and cardiovascular disease. The remaining studies focused on multimorbidity, generally in older people.
Stokes et al. (2015) (PLoS One) Effectiveness of case management for ‘at risk’ patients in primary care: a systematic review and meta-analysis	A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individualʼs and familyʼs comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.	1.To synthesize the evidence for the effectiveness of case management in primary care for ‘at risk’ patients. 2.To explore whether the effectiveness of case management in primary care is moderated by the particular model of case management implemented, context, and study design.	Studies were included in this review if they met the following criteria: Population: adults (18+) with long-term condition(s) (while prevalence of multimorbidity (i.e., ‘complex’ cases) is highest in the elderly, the absolute numbers affected are greater in people under 65). Intervention: adopting methods to identify ‘at-risk’ patients suitable for CM, with the aim of preventing acute exacerbations of symptoms, and/or secondary care utilization among those at higher risk; CM, including all of the following activities: case-finding; assessment; care planning; care co-ordination; regular review, monitoring, and adaptation of the care plan; primary care/community-based management (regardless of where the case was first identified); Comparison: usual care or no CM; Outcome categories: Health – self-assessed health status, mortality; Cost – total cost of care, healthcare utilization (primary and nonspecialist care and secondary care separately), and; Satisfaction – patient satisfaction; Study design: Quantitative empirical research, meeting Cochrane Effective Practice and Organization of Care (EPOC) Group study design criteria: RCTs, non-RCTs (nRCTs), controlled before and after studies (CBA), and interrupted time series (ITS). Exclusion criteria: Case management solely targeting care for patients with mental health problems, although mental health conditions could be included where they were comorbidities alongside long-term physical conditions; Hospital discharge planning (short-term management to facilitate the transition from hospital to home; Non-English-language papers and gray literature. 36 studies (from 1994 to 2013).
Althaus et al. (2011) (Annals of Emergency Medicine) Effectiveness of interventions targeting frequent users of EDs: a systematic review	The coordination of health services on behalf of the patient by multidisciplinary teams composed of nurses, social workers, and physicians. Coordination tasks were allocated to a case manager, who guided the patient through the care process and provided social support. The locus of intervention was generally not limited to the hospital, often extending to the community. The teamʼs availability was limited to weekdays and during the daytime.	The purpose of this systematic review was to critically evaluate experimental and observational studies describing interventions targeting frequent users of hospital EDs	There were RCTs, non-RCTs, ITS studies, and controlled and uncontrolled before-and-after studies assessing interventions targeting adult (from 16 years of age) frequent users of hospital EDs. At least 1 outcome measure had to reportedly meet the inclusion criteria. The primary outcome was ED use, and the secondary outcomes were costs or cost-effectiveness analyses. Other outcomes were clinical outcomes, social outcomes, healthcare use (other than ED), and patient and staff satisfaction. No language or publication date restrictions were imposed. Studies that targeted only specific patient subgroups were excluded to increase homogeneity and comparativeness between studies, and because the authors focused on interventions for patients selected on a single, simple inclusion criterion, namely, the frequency of ED use. 11 studies (from 1985 to 2009): 3 RCTs, 1 controlled before and after, 2 controlled, and 6 uncontrolled before-and-after studies
Hickam et al. (2013) (Agency for Health Care Research and Quality) Outpatient Case Management for Adults with Medical Illness and Complex Care Needs	A process in which a person (alone or in conjunction with a team) manages multiple aspects of a patientʼs care. Key components of CM include planning and assessment, coordination of services, patient education, and clinical monitoring.	This report summarizes the existing evidence addressing the following key questions: Key Question 1: In adults with chronic medical illness and complex care needs, is case management effective in improving: (a)patient-centered outcomes, including mortality, quality of life, disease-specific health outcomes, avoidance of nursing home placement, and patient satisfaction with care? (b)quality of care, as indicated by disease-specific process measures, receipt of recommended healthcare services, adherence to therapy, missed appointments, patient self-management, and changes in health behavior? (c)resource utilization, including overall financial cost, hospitalization rates, days in hospital, ED use, and number of clinic visits (including primary care and other provider visits)? Key Question 2: Does the effectiveness of case management differ according to patients’ characteristics, including but not limited to: particular medical conditions, number or type of comorbidities, patients’ age and socioeconomic status, social support, and/or level of formally assessed health risk? Key Question 3: Does the effectiveness of case management differ according to intervention characteristics, including but not limited to: practice or healthcare system setting; case managers’ experience, training, or skills; case management intensity, duration, and integration with other care providers; and the specific functions performed by case managers? The analytical framework depicts the Key Questions in the context of the populations, intervention, and outcomes considered in the review.	Populations of interest A main criterion in choosing studies for inclusion was the existence of complex care needs. The studies included sometimes addressed populations in which psychiatric problems, such as depression or dementia, were important comorbid conditions. Studies in which the primary clinical problem was a psychiatric disorder (other than dementia) and in which CM was used primarily to manage mental illness or a substance abuse disorder were excluded. Interventions Studies in which the case manager was a licensed independent practitioner, such as a primary care physician, a geriatrician, or a nurse practitioner, were excluded. This is because such CM is part of the primary medical care provided to the patient rather than a separate clinical service. Comparators In most studies, CM is compared with usual care (i.e., care without a CM component). Usual care can vary across studies, but in most cases the comparator was the same milieu of clinical services without a distinct CM component. When a study compared two or more different types of CM, then the comparator was the alternative type of CM. Timing A level of longitudinal engagement with patients was a criterion for study inclusion. Studies that provided CM for only short durations (30 days or less) were excluded. This led to the exclusion of many studies that evaluated short-term post-hospitalization programs (often termed ‘transitional care’ programs). Such programs fall into a large category of inpatient discharge planning activities that are beyond the scope of this review. Settings Only studies on the outpatient setting, including primary care, specialty care, and home care settings, were considered. No geographic al limitations were applied. Types of Studies Randomized trials and observational studies pertinent to the Key Questions were included. The observational studies included studies using nonexperimental designs such as cohort, case–control, and pre-post designs. Previously published systematic reviews were not included as part of the evidence base but were compared with the results of this review. 109 studies (from 1989 to 2011). The majority were randomized trials. The studies were sorted by patient population and were assigned to the following categories: Older adults with one or more chronic diseases (20 studies/30 articles); Frail elderly (14 studies/17 articles); Dementia (15 studies/26 articles); Congestive heart failure (12 studies/12 articles); Diabetes mellitus (12 studies/24 articles); Cancer (6 studies/8 articles); Chronic infections (HIV or tuberculosis) (15 studies/17 articles); Other medical problems (15 studies/19 articles).
Low et al. (2011) (BMC Health Services Research) A systematic review of different models of home and community care services for older persons	Case management was defined as interventions where a central worker provided assessment, care planning, coordination of services and ongoing follow-up.	The aim of this review was to evaluate the outcomes of case management, integrated care and consumer-directed home and community care services for older persons, including those with dementia.	Inclusion criteria were as follows: (1)written in English; (2)evaluating the delivery of case-managed, integrated, or consumer-directed home and community services using quantitative outcomes. Home and community services could include but not be limited exclusively to medical care; (3)community dwelling, with either a majority of the sample aged 65 years and over or with a subsample of persons aged 65 and over for whom results were reported separately; (4)the sample was not selected because patients had a specific medical illness, except for dementia. There were seven RCTs (three focusing on individuals with dementia), two nonrandomized trials and three observational studies with nonmatched controls comparing case-managed care to usual noncoordinated care. The publication dates of the studies included in the review ranged from 1998 to 2008.
Purdy et al. (2012) (National Institute for Health Research) Interventions to reduce unplanned hospital admission: a series of systematic reviews	Case management in hospital/healthcare systems is a collaborative practice model including patients, nurses, social workers, physicians, other practitioners, caregivers, and the community. The case management process encompasses communication and facilitates care along a continuum through effective resource coordination. The goals of case management include the achievement of optimal health, access to care, and appropriate utilization of resources, balanced with the patientʼs right to self-determination.	The overall aim of this systematic review was to evaluate the effectiveness and cost-effectiveness of interventions to reduce UHA (unplanned hospital admissions). The primary outcome measures of interest were reduction in risk of UHA or readmissions to a secondary care acute hospital, for any specialty or condition.	Inclusion criteria were: all controlled studies, namely RCTs, controlled clinical trials, controlled before-and-after studies, and ITS, in which one of the outcomes was number of unplanned hospital admissions or readmissions; that were either published in English or had an English abstract; that were carried out in an OECD country. This latter criterion was chosen so that the results could be broadly applicable to the UK and other similar health systems. Studies were excluded if unplanned admissions could not be separated from planned or elective admissions using data provided in the paper or by the authors. 29 controlled studies (from 1992 to 2010), namely, randomized trials (RCTs), controlled clinical trials, controlled before-and-after studies, and ITS. Of these 29 studies, 11 concerned the elderly, 6 were on heart failure, 4 were on Chronic obstructive pulmonary disease (COPD), and 7 covered a range of other conditions such as cancer, diabetes, dementia, and stroke.
Soril et al. (2015) (PLoS One) Reducing frequent visits to the ED: a systematic review of interventions.	Broadly defined case or care management (CM) is considered a comprehensive, interdisciplinary approach taken to assess, plan, personalize, and guide an individualʼs health services to promote improved patient and health system outcomes. A single point of contact (e.g., an individual described as either a case manager, care manager, or ED consultant) is assigned to a frequent ED user and is tasked with brokering access and guiding the patient through their customized care process, which may extend beyond the normal continuum of the ED and in-patient care, into the community.	The objective of this research was to establish the effectiveness of interventions aimed at reducing ED utilization, in comparison to usual care, for individuals who are frequent users of the ED.	Studies were included if: they reported original data; had a control group (controlled trials or prospective comparative cohort studies); were set in an ED or acute care facility; focused on a general adult frequent ED user population; and examined the impact of an intervention to reduce the ED utilization of frequent ED users. No fixed definition of frequent user was applied; any definition used in the studies considered was accepted. Studies were excluded if they did not meet the above criteria, or if they only assessed a specific demographic or clinical group of frequent users (e.g., seniors, those with asthma, migraine sufferers, homeless). 2 RCTs and 10 comparative cohort studies (from 2000 to 2014).
You et al. (2013) (Journal of Aging and Health) Case managed community aged care: what is the evidence for effects on service use and costs?	The Case Management Society of Australia formally defines case management as a ‘collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individualʼs holistic needs through communication and available resources to promote quality cost-effective outcomes’.	The study provides a systematic review to summarize the effects of CMCAC (CM in community-aged care) on service use and costs, reveal the value of CMCAC interventions, and further assist stakeholders such as aged care policy makers, aged care organizations, and case managers to make informed decisions about their services.	Types of study included: RCTs and observational comparative studies that examined the effects of CMCAC on service use and/or costs. Only studies in English and published in refereed journals or publications of equivalent standard were included. No publication date restriction was imposed. Types of participant: Participants in the studies reviewed were community-dwelling frail elderly (people aged 65 and older who suffered from age-related health problems such as functional disabilities and cognitive problems. Studies involving young adults or children, or patients with single chronic diseases were excluded. Types of intervention: This review only focused on independent CM interventions specifically applied in the community aged care setting. Studies involving more than one or multifaceted identifiable core CM functions, such as assessment, care planning, care coordination, monitoring, and so on were of particular interest. Case management interventions with the following features were excluded: applied in other community care settings, such as primary care and community mental health (studies based on primary care settings where enrolled participants had dementia instead of one specific chronic disease, such as diabetes, were included); medically focused interventions (such as some disease programs) aiming to meet participants’ medical rather than holistic care needs; single or simple preventive measure (e.g., in-home visits) differing from comprehensive CM interventions; CM playing a small part in a multifaceted intervention or an integrated care delivery system/model. 21 studies (from 1985 to 2010): 16 RCTs and 5 comparative observational studies.
Eklund and Wilhelmson (2009) (Health and Social Care in the Community) Outcomes of coordinated and integrated interventions targeting frail elderly people: a systematic review of RCTs.	CM was defined as the coordination of various system components for a successful outcome. It entails the assessment of a personʼs longer-term care needs followed by appropriate recommendations for care, monitoring, and follow-up. Five core CM activities are assessment, planning, linking, monitoring, and advocacy. A cornerstone for improving care coordination is effective information transfer between different caregivers and care levels.	The aim of this study was to review RCTs on integrated and coordinated interventions targeting frail elderly people living in the community, their outcome measurements, and their effects on the client, the caregiver and healthcare utilization.	The inclusion criteria were original article; integrated intervention including CM or equivalent coordinated organization; frail elderly people (elderly defined as 65 years or older) living in the community; RCTs; in the English language, and published in refereed journals between 1997 and July 2007. The exclusion criteria were studies targeting a specific characteristic of frailty, such as a single diagnosis or symptom; articles published before 1997; trials performed in Africa, Asia and South America; no origin or authors listed; reviews and editorials. 9 RCTs (from 1998 to 2006).
Joo and Liu (2017) (International Nursing Review) Case management effectiveness in reducing hospital use: a systematic review.	CM is a ‘collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individualʼs and familyʼs comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes’.	The specific aim of this systematic review was to identify and then synthesize evidence from studies published within the last 10 years on the effectiveness of CM interventions for hospital use outcomes. The research question was ‘Do CM interventions affect hospital use by individuals with chronic illnesses?’	Inclusion criteria: (1)primary research that used RCT for the study design; (2)implementations of CM interventions that had the express aim of reducing hospital use by study participants with chronic illnesses. Interventions could include any follow-up care services and transitional care services defined by the Case Management Society of America as components of CM; (3)interventions that were transferred from hospital settings to communities and that focused on transitional care services; (4)studies that included populations who were diagnosed with chronic illnesses (≥18 years of age; the disease must have been listed by the Centers for Disease Control and Prevention (2016); (5)interventions that evaluated primary hospital use outcomes such as hospital readmissions, ED visits, and length of stay in hospital; (6)studies that included psychological outcomes or cost analyses; (7)studies published in English. Exclusion criteria; Studies that mixed with other interventions or implemented CM as part of the main intervention were excluded. Studies that only described protocols for future study and planned post-test outcomes with CM intervention were also excluded as irrelevant. 10 RCTs (from 2007 to 2014).
Latour et al. (2007) (Journal of Psychosomatic Research) Nurse-led case management for ambulatory complex patients in general health care: a systematic review.	Case management is concerned with an optimization of multidisciplinary treatment for complex patients and the integral care needs of the individual patient without focusing on only one specific illness or population (as in disease management). The criteria used to identify case management were assessment of the clientʼs needs, development of a comprehensive service plan, arrangement of service delivery, monitoring and assessment of services, evaluation, and follow-up.	The aim was to summarize evidence for the effectiveness of post-discharge nurse-led case management for complex patients by means of a systematic review.	Studies published from 1966 until June 15, 2005, were eligible for inclusion in the review; no language restrictions were applied. Studies considered for inclusion in this review focused on ambulatory patients over 18 years of age and defined as complex. Studies were excluded if they focused on only one specific disease, with less attention paid to other vulnerabilities or comorbidities (e.g., disease management protocols) or when the CM focused solely on psychiatric/mental health care. Interventions had to be implemented in an ambulatory setting. The criteria used to identify CM were assessment of the clientʼs needs, development of a comprehensive service plan, arrangement of service delivery, monitoring and assessment of services, evaluation, and follow-up. There were no limits with regard to the types of intervention. Studies were excluded if the care was only guided by chronic disease management protocols or guidelines, or if the case manager was an administrative case manager (employed by an insurance company). Studies with one or more of the following outcome measures were included: readmission, duration of hospital readmissions, ED visits, functional status, quality of life, and patient satisfaction. 10 studies (from 1993 to 2004).
Oeseburg et al. (2009) (Nursing Research) Effects of case management for frail older people or those with chronic illness: a systematic review	In case management, an individual or a small team is responsible for navigating the patient through a complex process in the most efficient, effective, and acceptable way.	The aim of this study was to review RCTs systematically to determine the effects of a patient advocacy case management model on service use and costs in people with a somatic chronic disease or in frail older people living in the community.	To be considered for inclusion, studies had to evaluate CM interventions. Eligible studies reported RCT on the patient advocacy CM model and evaluated service use and costs. Studies on mental healthcare or acute care, and studies applying other CM models such as hospital-based CM, interrogative CM, disease management programs, or programs for discharge follow-up were excluded. Studies focusing on children, adolescents, caregivers, substance abuse, or professional reintegration were also excluded. 8 RCTs (from 1995 to 2007).
Thomas et al. (2014) (Nursing Research and Practice) Examining end-of-life (EOL) case management: systematic review.	A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individualʼs and familyʼs comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes	A systematic literature review with the aim of understanding what research evidence exists on EOL case management.	The search was limited to English language research articles. Although it identified some general reviews of CM, these were excluded as none focused on end-of-life case management (EOL CM). Around 380 discussion or opinion articles on EOL CM were also rejected for review. 17 studies (from 1994 to 2010).
Boult et al. (2009) (Journal of the American Geriatric Society) Successful models of comprehensive care for older adults with chronic conditions: evidence for the Institute of Medicineʼs ‘Retooling for an Aging America’ report.	Care management (CM) is a collaborative model that generally involves a nurse or social worker helping chronically ill patients and their families to assess problems, communicate with healthcare providers, and navigate the healthcare system. Care managers are usually employees of health insurers or capitated healthcare provider organizations.	This study sought to identify models of comprehensive care that high-quality research has shown to be capable of improving the quality, outcomes, and efficiency of care for chronically ill older persons. The considerable heterogeneity of models, target populations, and research methods precluded meta-analyses (or even systematic reviews) of the models’ positive and negative effects. Instead, the study strove to identify promising models that should be considered for replication or further study.	MEDLINE was searched for articles published in English between January 1, 1987, and May 30, 2008, that reported statistically significant positive outcomes (improvements in the quality or efficiency of care, or in patients’ quality of life, functional autonomy, or mortality) from high-quality studies of clinical models staffed primarily by healthcare professionals to provide comprehensive health care to older persons with several chronic conditions. Models were considered to be comprehensive if they addressed several health-related needs of older persons, such as care for several chronic conditions, for several aspects of one condition, or for persons receiving care from several healthcare providers. Studies of more narrowly focused models such as innovations in cataract surgery and management of single medications were excluded. Studies were considered to be of high quality if they met five criteria: strength of design (reviews, meta-analyses, or controlled trials with equivalent concurrent control groups), adequacy of sample (adequate number of representative, chronically ill participants: 65), validity of measures, reliability of data collection techniques, and rigor of data analysis. 12 RCTs and 1 QE study (from 1999 to 2007).
Chiu and Newcomer (2007) (Professional Case Management) A systematic review of nurse-assisted case management to improve hospital discharge transition outcomes for the elderly.	The interventions varied widely in scope and duration, but common elements included home visits, telephone contact, and training in self-management. Liaison and coordination with patients’ physicians and other providers was a feature in about one third of the programs.	The following questions were addressed: What are the effects of the interventions on unscheduled readmission rates in hospital in comparison with usual care? What are the effects of the interventions on ED visits in comparison with usual care? What are the effects of the interventions on the length of stay during readmission in comparison with usual care? What are the effects of the interventions on mortality rates in comparison with usual care? What are the effects of the interventions on total Medicare care expenditures in comparison with usual care?	Inclusion criteria were links to full-text, clinical trials, and randomized clinical trials. Additional references were identified from the original citations. Of 323 citations identified in this manner, 89 were excluded because they dealt with the effectiveness of specific medical and/or surgical treatments; not with discharge transitions. Another 166 were excluded because they were not related to elderly and/or hospital discharge. Also excluded were 12 articles focusing on ED uses, 17 articles related to psychiatric patients, 22 articles that were not clinical trials, and 1 article that did not measure any hard outcomes. 15 clinical trials (from 1999 to 2006).
Hallberg and Kristensson (2004) (Journal of Clinical Nursing) Preventive home care of frail older people: a review of recent case management studies	CM interventions may include a comprehensive assessment, care planning as well as information and referral, direct nursing care services and coordination and monitoring of services. It should perhaps also include self-care management, general and specific health and care education, and healthcare strategies involving the older person as well as the informal caregiver and formal caregivers if they have limited training in geriatric care.	This paper explores the empirical literature for studies of case/care management (CM) interventions for community-dwelling frail older people and especially with regard to the content of the interventions, the nurseʼs role, and the outcomes.	The search was limited to studies published in English that included an abstract and that concerned people 65 years or older. Studies focusing on a particular group of diseases, such as chronic obstructive pulmonary disease, stroke and stroke rehabilitation, dementia-related disease, or heart disease, were excluded. 26 studies (from 1980 to 2004).
Hutt et al. (2004) (Kingʼs Fund) Case-managing long-term conditions: what impact does it have in the treatment of older people?	Case management has been defined as the process of planning, coordinating, managing and reviewing the care of an individual. The broad aim is to develop cost-effective and efficient ways of coordinating services in order to improve quality of life. It has its roots in social care, where it was developed as a mechanism for delivering holistic individualized care, tailored to the needs of people with complex health and social care problems.	This review of published research on case management aims to: describe methods of patient selection; evaluate the impact of case management on healthcare utilization and patient health; review the reported cost-effectiveness of case management.	Inclusion criteria: – CM provided by or linked to healthcare services with or without the inclusion of social care and other services; – CM intervention lasting at least three months; – the outcomes measured included a change in use of healthcare resources (although this may not have been the main focus of the study); – studies of disease-specific models of CM if they reported both general and disease-specific service use and outcomes. Studies about mental health CM or hospital-based CM with no community/primary care component were excluded. In view of current interest in CM for older people with chronic disease and complex needs, the search was restricted to studies in which the majority of subjects were over 65. 19 studies (from 1984 to 2003): 14 RCTs, 3 non-RCTs, 2 before-and-after studies.
Joo and Huber (2013) (International Nursing Review) An integrative review of nurse-led community-based case management effectiveness	Care coordination is ‘the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patientʼs care to facilitate the appropriate delivery of healthcare services’	The purpose of this integrative review was to identify and synthesize the quantitative and qualitative evidence of the effectiveness of CM.	Types of study included: – limited to years 2000–2012; – limited to publications in English; – titles reviewed – included studies looking at patient outcomes. Types of study excluded: – intervention-launching articles, reviews, case manager development articles and studies where CM was not the main intervention. 18 studies (from 2000 to 2013): 7 RCTs and 11 of other type.
Kumar and Klein (2013) (Journal of Emergency Medicine) Effectiveness of case management strategies in reducing ED visits in frequent user patient populations: a systematic review	Case management (CM) is defined as a ‘collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individualʼs health needs through communication and available resources to promote quality cost-effective outcomes’.	The CM literature was systematically reviewed to determine the proven effectiveness of this model in the frequent ED user patient population. This review focuses on evidence of the impact of CM as an intervention in improving outcomes of frequent users of ED care. The primary outcome of interest was ED utilization, although some studies did report cost analyses and psychosocial outcomes as well.	Limits used for each search phase included publications dating from 1990 to April 2011, human subjects, age >18 years, and English language. The targeted study population was patients >18 years of age designated as frequent users of the ED without specific limitations on medical condition, reason for ED utilization, or complaint. The interventions studied had to be identified as CM interventions and the study had to report at least one outcome with this intervention. 12 studies (from 1996 to 2011), including both prospective and retrospective studies, randomized and non-RCTs, case–control studies, and pre- and post-intervention analyses using historical controls.
Lupari et al. (2011) (Journal of Clinical Nursing) ‘We’re just not getting it right’ – how should we provide care to the older person with multimorbid chronic conditions?	Case management was defined as a nurse providing targeted care to individual patients, which included clinical and social support, assessment, planning, implementation and monitoring or organizing care provision to prevent and/or minimize exacerbations in the individualʼs chronic condition(s).	The aim of this literature review was to appraise available research and service evaluation evidence on nurse-led case management services targeting older people with multiple chronic conditions in their own homes.	One inclusion criterion established that the studies should compare a CM intervention with usual care in the home setting. Studies would only be included if they were able to answer the question ‘Is nurse-led case management for older people with multiple chronic conditions more effective than usual care in their own homes?’. Studies were included if published in English. 8 studies (from 1996 to 2008).