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Table 1 Transformation of dimensions of continuity of care to aims of case management in palliative care sent to the expert panel for feedback in round 1

From: What is case management in palliative care? An expert panel study

 

Aims of case management, sent to the expert panel at start of round 1

Dimensions of continuity of care

1

Delivery and/or coordination of care is aimed at quality of life and death (not at curing the patient)

 

2

Care is longitudinal; it lasts for a minimum of two weeks and lasts as long as necessary

Continuity of care has a temporal dimension, it is longitudinal in nature; the patient’s treatment parallels his or her progress even though the individual health care provider, specific treatment modalities, or specific site of care may change. Episodes are consecutive and related

3

Care is individual: it is tailored to the individual needs of the patient

Continuity of care has an individual dimension, the care is planned with and for the patient and family with consideration for their specific needs

4

Care is flexible; it is adjusted to the pace of the patient. This means for example that the frequency of contacts can vary over time

Continuity of care is characterized by flexibility. A flexible service system relieves the patient of pressures that may be placed on him or her to exhibit ‘progress’ or to move ‘forward’ along a continuum. The flow in services should correspond to changes in the patient’s circumstances and needs

5

The relationship with the patient is central in care; the patient experiences care as familiar and close

Continuity of care has a relationship dimension, either in contacts with an individual provider or in an ‘institutional alliance’ in which the patient develops closeness with more than one service provider at a time. The patient is able to rely, over time, on having associations with a person or persons who are interested in him or her and who respond to him or her on a personal level

6

Care is comprehensive; the patient can receive a diverse array of care and support according to needs and wishes

Continuity of care as a cross-sectional dimension; it is comprehensive in a sense that it consists of a variety of services related to the many needs of the patient. It has a distinctly interdisciplinary quality.

7

Care is characterised by communication; between the case manager and the patient and between the case manager and other care providers communication is clear and sufficient

Continuity of care has a dimension of communication, both between the patient and service providers and among the various service providers involved in the care. One aspect of this is continuity in information

8

Care is accessible; the case manager can be reached and care is low-threshold and financially accessible

Continuity of care is characterized by accessibility, the patient will be able to reach the service system when she/he needs it and in a way in which she/he can handle, both psychologically and financially. The patient does not experience barriers to service delivery, whether they be of a physical, psychological, or economic nature. Implicit in this dimension is the patient’s access to 24-hour crisis intervention

9

Care is delivered at home or where the patient is staying

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