Which of the following patients is likely to benefit most from referral for case management?
a. Child injured in a playground accident
b. Elderly patient with total hip replacement
c. A 49-year-old man in the emergency department with chest pain
d. A 20-year-old with appendectomy
ANS: B
A
Injuries sustained to a child on a playground are likely to be different from many other childhood injuries and thus outcomes will be less predictable. The injury may also be minor in nature and not need the involvement of a case manager.
B
The best referral to case management is a patient who falls within a specific diagnostic group and whose outcomes can be reasonably predicted within a set period of time.
C
A middle-aged man with chest pain does not yet have a diagnosis that would put him in a diagnostic group benefiting from case management.
D
A young person with an acute illness requiring surgery is likely to have an uncomplicated recovery.
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