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Table 6.2.

Reviews of Case Management Models, 1995-2004

Reviewers

Type of
review

Case
management
type

No.of
studies

Narrative

ACT

8

Inclusion criteria
Articles 1990-1994
reporting resuls of
randomized
controled trials

Narrative

ACT

25

Randomized
controlled trials

Baroner &
Gerber (1998)

Narrative

ACT

22

No specifics

Baroner &
Gerber (1998)

Narrative

25

No specifics

Burns & Santos
1995
Bond,
Drake,Mueser, &
Latimer (2001b)

Bedell, Cohen &
Sullivan (2000)
Holloway, Oliver,
Collins, 7 Carson
(1995)

Narrative
Narrative

CM dan ICM
Full service,
broker, and
hybrid (IGM,
rehabilitation
, strength,
and clinical
All CM
models

8
23

Reviews of CM
Outcome studies,
all designs

Outcomes
Fewer days hospitalization, improved
clinical outcomes; high rates of clients
remaining in treatment; high rates of client
and family satisfaction
Reduced hospital use; increased housing
stability; moderately improved symptomp
and subjective quality of life
Decreased number of hospitalization;
decreased length of hospital stay;
increased involvement with mental helath
treatment;improved symptomatology;
client and family more satisfied;improed
residential stability; cost less because of
reduced hospitalization.
Tendency to increase use of mental health
services; increase level of social
funtioning; increased hospital use
Full service increased sevice retention; full
service reduced hospitalization; full srvice
and ICM, modst cost savings; full service
increased satisfaction; broker model,
increased cost.
Decrease in hospital use and length of
stay-attributed to ACT; CM may increase
use of other sevice; satisfaction with CM;
some improvement in quality of life; social
functioning mixed; no increase in family
burden; improved social
network/relationship;cost varied-less faor

ACT and ICM improved housing stabiity. strength- 22 ACTs-faithfl to model randomized controlled trials and quasiexperimental 75 Assesses at baseline and follow-up for two groups 8 5 19 11 All studies of strength-based model Randomized controlled trials with standard care control Randomized controlled trials comparison standard inpatient/outpatien t treatment. coid. Fewr hospitalization. two studies found reduced symptoms.shorter duration of hospital stay. drake&resnick (1998) Sullivan & Rapp (2002) Simmonds. reduced time in hospital. ACT less costly.lower cost. rehabilitation increased use of other mental health services. including those by suicide. ICM. broker. promoted residential stabilty. broker.philip. but limited to those with reduced hospitalization Retention in mental health treatment.vocational functioning. Marriot&tyrer (2001) Herdelin &Scott (1999) Marshall. strengthbased. shorter hospital stay. Fewer deaths. improved social functioning. ICM.improved independent living.greater client satisfaction. some vidence for client and family satisfaction. ACT reduced symptomatology.educational. ACT cost savings-affefted by context Decreased hospitalization. withdrawal deterioration of gains.leisure time activities. excludes studies focused on specific diagnoses Randomized controlled trials- ACT ACT reduced rate and duration of hospitalization. and ICM Narrative ACT.higher social functioning. Gray. bond. broker increased rates of hospitalization.lower cost of care.higher .Lockwood& Narrative ACT. and rehabilitation Narrative Metaanalysis Metaanalysis Metaanalysis Strengthbased Multydiscipli nary CMH teams-ICMtype teams PACT CM-broker.lower symptomatology. CM. moderate effect on symptomatology and quality of life. trend toward higher mortality.Sco & Dixon(1995) Mueser. fewer dropouts. and independent living.

tentative increase in hospital stay. less costly. Outcomes More days in stable housing-living independently and fewer days homeless. ACT no clear-cut advantages Prevention of hospitalization. cost less Increase in contact with clients.less costly. Client more satisfied. lindsay. but cost consideration does not favor ACT Less likely to be hospitalized. less than 50% attrition Case management type No.of studies Inclusion criteria 17 Randomized controlled trials Metaanalysis ACT versus standard care ACT versus hospital based rehabilitation Metaanalysis ACT versus CM 9 Metaanalysis Metaanalysis PACT (full support) ICM 24 6 3 Randomized controlled trials Randomized controlled trials No specifies No specifies hospitalization. increase in .cost-increase cost for providers. et all (1998) Marshall & Creed (2000) high quality methods standardized measures. but may reduce societal costs.less likel to be unemployed. Carruthers.quality of life better.increase in hospital admissions.Mo rris. shorter hospital stay.tentative more compliance with medication.Leslie. less likely to be hospitalized.more likely living independently Shorter hospital stay.Green (2004) based clinical Reviewers Type of review Marshall & Lockwood (1999) Metaanalysis Marshall &Lockwood (1999) Marshal & Lockwood (1999) Corey.functioning better.

less family burden.shorter hospital stay. shorter hospital stay. greater client and family satisfaction with care. lower cost ACT vs clinical-ACT fewer hospital admission and smaller proportion of clients admitted to hospitals.Ciguras & stuart (2000) Metaanalysis ACT and clinical versus usual treatment. pre-post cost ACT and clinical vs standard treatment-clients admitted more frequently to hospital. ACT versus clinical Bond. fewer hospitalization.smaller proportion of clients admitted to hospital. more contacts with mental health treatment. clinical-greater number of contacts with mental health services Retention rate higher. quasiexperimental. Mc grew & skete (1995) Metaanalysis ICM (Assertive Outreach) 44 9 Randomized controlled rials and quasiexperimental Experimental . .