Notes
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“Disease management” is a system of coordinated health-care interventions and communications for populations with conditions in which patient self-care efforts are emphasized. The “disease management model” utilizes teams of nurses and care managers who may assess patients over the phone. Disease management efforts include regular assessment of known patient populations to identify subtle changes that could affect their overall state of health. Early identification of changes allows involved clinicians to guide self-care interventions, containing the need for more extensive medical intervention.
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Frankel, S.A., Bourgeois, J.A., with Colin Leary. (2018). Models for Managing Complex Cases in Both Inpatient and Outpatient Settings. In: Frankel, S., Bourgeois, J. (eds) Integrated Care for Complex Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-61214-0_4
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