DOI QR코드

DOI QR Code

Experiences of Transitional Care for Medicaid Case Managers

의료급여관리사의 재가전환관리 경험

  • Received : 2023.03.03
  • Accepted : 2023.10.06
  • Published : 2023.10.31

Abstract

Purpose: This phenomenological study tried to understand the essence of the transitional care experience of medicaid case managers and its structural meaning. In addition, it was attempted to establish a system of transitional care and seek support measures for medicaid case managers. Methods: The participants of this study were 7 medicaid case managers who had spent more than 1 year and 6 months in medicaid pilot project. Data were collected with individual in-depth interviews from June to December 2021. The data were analyzed by Giorgi's phenomenological analysis method. Results: The seven constituents derived from the results of this study were 'struggle to establish a living environment', 'dedication to supporting independent living', 'anxiety about safety', 'pressure on care responsibilities', 'distress in building the pilot project', 'pride in role', and 'expectation for improvement'. Conclusion: The study results provide a comprehensive understanding of the transition care reality for medicaid case managers. They also shed light on managers' perceptions and attitudes. These findings can serve as fundamental information for establishing support measures for medicaid case managers and transitional care systems.

Keywords

References

  1. Ministry of Health and Welfare. Guideline for medicaid program in 2022. Sejong: Ministry of Health and Welfare; 2022. p. 677.
  2. Oh JJ, Oh SE. Case management for long-term hospitalization by medical aid beneficiaries: Suggestions for successful operation and stabilization. Korean Public Health Research. 2015;41(4):1-13. https://doi.org/10.22900/kphr.2015.41.4.001
  3. Ministry of Health and Welfare. Pilot project mannual of medicaid. Sejong: Ministry of Health and Welfare; 2021. p. 154.
  4. Kim SO, Cho JH. Trends of research on the case management of medicaid beneficiaries in Korea. Journal of Korean Public Health Nursing. 2015;29(3):412-425. https://doi.org/10.5932/JKPHN.2015.29.3.412
  5. Weber LAF, Lima MADS, Acosta AM, Maques GQ. Care transition from hospital to home: Integrative review. Cogitare Enfermagem. 2017;3(22):e47615. https://doi.org/10.5380/ce.v22i3.47615
  6. Luther B, Barra J, Martial MA. Essential nursing care management and coordination roles and responsibilities: A content analysis. Professional Case Management. 2019;24(5):249-258. https://doi.org/10.1097/NCM.0000000000000355
  7. Osakwe ZT, Barron Y, McDonald MV, Feldman PH. Effect of nurse practitioner interventions on hospitalizations in the community transitions intervention trial. Nursing Research. 2021;70(4):266-272. https://doi.org/10.1097/NNR.0000000000000508
  8. Dale B, Hvalvik S. Administration of care to older patients in transition from hospital to home care services: Home nursing leaders' experiences. Journal of Multidisciplinary Healthcare. 2013;6:379-389. https://doi.org/10.2147/JMDH.S51947
  9. Feldman PH, McDonald MV, Trachtenberg MA, Schoenthaler A, Coyne N, Teresi J. Center for stroke disparities solutions community-based care transition interventions: Study protocol of a randomized controlled trial. Trials. 2015;16:32. https://doi.org/10.1186/s13063-015-0550-3
  10. McAlister FA, Grover S, Padwal RS, Youngson E, Fradette M, Thompson A, et al. Case management reduces global vascular risk after stroke: Secondary results from the The preventing recurrent vascular events and neurological worsening through intensive organized case-management randomized controlled trial. American Heart Journal. 2014;168(6):924-930. https://doi.org/10.1016/j.ahj.2014.08.001
  11. Chow SK, Wong FK. A randomized controlled trial of a nurse-led case management programme for hospital-discharged older adults with co-morbidities. Journal of Advanced Nursing. 2014;70(10):2257-2271. https://doi.org/10.1111/jan.12375
  12. Amjad H, Wong SK, Roth DL, Huang J, Willink A, Black BS, et al. Health services utilization in older adults with dementia receiving care coordination: The MIND at home trial. Health Services Research. 2018;53(1):556-579. https://doi.org/10.1111/1475-6773.12647
  13. Lee HJ, Kim YK, Oh EG. A systematic review on nurse-led transitional care programs for discharged patients from hospital to home. Journal of Korean Clinical Nursing Research. 2017;23(3):376-387. https://doi.org/10.22650/JKCNR.2017.23.3.376
  14. Verhaegh KJ, MacNeil-Vroomen JL, Eslami S, Geerlings SE, de Rooij SE, Buurman BM. Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health Affairs. 2014;33(9):1531-1539. https://doi.org/10.1377/hlthaff.2014.0160
  15. Song MK, Yoo EK. Influencing factors on the work performance competence of medicaid case managers. Health and Social Welfare Review. 2015;35(1):211-242. https://doi.org/10.15709/hswr.2015.35.1.211
  16. Oh J, Oh S. Nurse case managers' experiences on case management for long-term hospitalization in Korea. Asian Nursing Research. 2017;11(4):283-289. https://doi.org/10.1016/j.anr.2017.11.002
  17. Korea Academy of Case Management. Case management. Seoul: Hakjisa; 2020. p. 476.
  18. Uittenbroek RJ, van der Mei SF, Slotman K, Reijneveld SA, Wynia K. Experiences of case managers in providing person-centered and integrated care based on The Chronic Care Model: A qualitative study on embrace. PLoS One. 2018;13(11):e0207109. https://doi.org/10.1371/journal.pone.0207109
  19. Thoma JE, Waite MA. Experiences of nurse case managers within a central discharge planning role of collaboration between physicians, patients and other healthcare professionals: A sociocultural qualitative study. Journal of Clinical Nursing. 2018;27(5-6):1198-1208. https://doi.org/10.1111/jocn.14166
  20. Oh JJ. On-the-job experiences of medical aid managers. Korean Journal of Occupational Health Nursing. 2009;18(1):84-97.
  21. Park EJ, Kim C. Case management process identified from experience of nurse case managers. Journal of Korean Academy of Nursing. 2008;38(6):789-801. https://doi.org/10.4040/jkan.2008.38.6.789
  22. Kim YC. Qualitative research methods. 3rd ed. Paju: Academypress; 2016. p. 715.
  23. Giorgi A. The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. Journal of Phenomenological Psychology. 1997;28(2):235-260. https://doi.org/10.1163/156916297X00103
  24. Giorgi A. The descriptive phenomenological psychological method. Journal of Phenomenological Psychology. 2012;43(1):3-12. https://doi.org/10.1163/156916212X632934
  25. Whiting L. Analysis of phenomenological data: Personal reflections on Giorgi's method. Nurse Researcher. 2001;9(2): 60-74. https://doi.org/10.7748/nr.9.2.60.s6
  26. Sandelowski M. The problem of rigor in qualitative research. Advances in Nursing Science. 1986;8(3):27-37. https://doi.org/10.1097/00012272-198604000-00005
  27. Hwang YH, Lee GE. Transition experiences of the elderly from long-term care hospital to home: Focusing on the elderly living alone of community care project. Journal of Korean Academy of Community Health Nursing. 2021;32(3):382-395. https://doi.org/10.12799/jkachn.2021.32.3.382
  28. Kim YD. Deinstitutionalization and building community-based personal social services: Community care that connects independence and interdependence. Health and Social Welfare Review. 2018;38(3):492-520. https://doi.org/10.15709/hswr.2018.38.3.492
  29. Byeon YK, Lee JH. Effect of job traumatic experience on post-traumatic growth among community-based mental health service workers: With a focus on moderating the effect of optimism and supervision. Journal of Social Science. 2018;29(1):23-45. https://doi.org/10.16881/jss.2018.01.29.1.23
  30. Choi HS. The effects of traumatic experiences on case management performance among case managers: Focusing on the mediating effects of posttraumatic stress and posttraumatic growth and the moderating effects of organizational support measures [dissertation]. Suwon: Kyonggi University; 2018. p. 1-161.
  31. Kim HJ, Roh EY, Cheong SJ, You JS. A phenomenological study on experiences in social worker's emotional labor: Focusing on the community welfare center. Journal of Korean Social Welfare Administration. 2014;16(4):163-195. https://doi.org/10.22944/kswa.2014.16.4.006
  32. Hellwig SD, Yam M, DiGiulio M. Nurse case managers' perceptions of advocacy: A phenomenological inquiry. Lippincott's Case Management. 2003;8(2):53-63; quiz 64-65. https://doi.org/10.1097/00129234-200303000-00002
  33. Shin JS, Kim YK. A phenomenological study on the fall experience of the Korean elderly living alone. Journal of Qualitative Research. 2017;18(1):66-77. https://doi.org/10.22284/qr.2017.18.1.66