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Effects of a community-based case management program for stroke patients : A randomized trial

Eun-Young Kim, PhD1, Chang-yup Kim, MD1, Kyung Ja June, PhD2, Yun-mi Kim, PhD3, and Jeeyeon Shin, RN1. (1) School of public health, Seoul National University, 28 Yeongun-dong Jeoro-gu, Seoul, 110-799, South Korea, 82-2-3673-4059, eenkuha@yahoo.co.kr, (2) Dept. of Nursing, Soonchunhyang University, 366-1 Ssangyong-dong, Chonan-si, Choongnam, 330-090, South Korea, (3) Department of Nursing, Seoul Health College, 212 Yangjidong Sujeonggu Seongnamsi, Kyunggido, South Korea

Stroke is the leading cause of death in South Korea, and health costs related to stroke accounted for an estimated 1.8% of total medical costs. The purpose of this study was to evaluate the effect of a case management program for stroke patients and their caregivers on health outcomes and medical costs. A total of 95 stroke patients were sampled in five urban, five suburban, and five rural areas. These subjects were randomly allocated to either an intervention group receiving a case management program or to a control group receiving the usual care. The case management program consisted of four home visits and two telephone counseling sessions for assessment, education, and provision of information. The main outcomes included physical and cognitive function, blood pressure, self-reported health status, and caregiver burden.

The findings indicated that systolic pressure decreased 6.9mmHg in the intervention group but increased 4.5mmHg in the control group (p=0.001). Diastolic pressure decreased 3.5mmHg in the intervention group but increased 1.5mmHg in the control group (p=0.031). Caregiver burden decreased 1.5 point in the intervention group but increased 0.5 point in the control group (p=0.005). The case management intervention was not associated with statistically significant changes in functional status and self-reported health status.

A community-based case management program may provide a cost effective approach to control high blood pressure in stroke patients and to decrease caregiver burden in their families.

Learning Objectives: The participant will be able to

Keywords: Case Management,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Healthy Lifestyles for Cardiovascular Health and Smoking Prevention

The 132nd Annual Meeting (November 6-10, 2004) of APHA