CMSA Today - Issue 4, 2021

INTERNATIONAL CASE MANAGEMENT

STAKING A CLAIM IN THE NEW WORLD:

C MSA’s 2021 Conference theme is “Staking a Claim in the New World.” What better way to kick off the conference than by sharing experiences and best practices from our colleagues around the globe? We know there may be differences in frame works or processes, but our commitment to improving the health of those we serve unites us and provides an opportunity to learn and support one another regardless of place, discipline or healthcare setting. GLOBAL PERSPECTIVES

CASE MANAGEMENT IN BRAZIL: RESULTS AND CHALLENGES In the last 3 years, the case management situation in Brazil seems to have changed. Initiatives taken from the private health system have begun to emerge, focused on reducing healthcare costs. However, in the last semester of 2020, a new movement has been gaining momen tum; the first Brazilian case management company was founded. Conceived by nurses and doctors, it is also centered on cost reduc tion but focuses on patient advocacy and patient engagement from the perspective of the patient’s own experience. The context of the COVID-19 pandemic and the global economic crisis, which also impacted Brazil and threatened the budget ary sustainability of private and public health systems, has led health decision makers and policy makers to adopt and think about implementing case management initiatives. Case management by specialized com panies is focused on hospital care environ ments and has reported promising results, such as: reduction of hospital stays by 25%; increasing the relevance of hospital admis sions from 85% to 97%; reduction of total hospitalization costs by up to 30% (MODU Case Management, 2020. General balance, Brasilia, Brasil). These results demonstrate that case management can increase the bed turnover rate and increase operational capacity.

The private healthcare system is com posed mainly of hospitals and centers for specialized care. The private system is accessed through health insurance plans and/or cash payment. Nurses have historically helped patients navigate the Brazilian Health System, guid ing access to health services and counseling patients and the community. However, these activities have always been done concur rently with activities that provide care and services to patients. Perhaps, since nurses are dedicated to both the healthcare system and case management simultaneously, this has affected the growth of case manage ment in Brazil. “The context of the COVID-19 pandemic and the global economic crisis, which also impacted Brazil and threatened the budgetary sustainability of private and public health systems, has led health decision makers and policy makers to adopt and think about implementing case management initiatives.”

AUGUSTO CABRAL/SHUTTERSTOCK.COM

CASE MANAGEMENT IN BRAZIL BY FRANCINO AZEVEDO, PhD, MSN, RN THE BRAZILIAN HEALTH SYSTEM Brazil is the largest country in Latin America and has two major health systems: one pub lic, and the other private. The Unified Health System (SUS) is the largest public health sys tem in the world and guarantees coverage for about 80% of the Brazilian population free of charge. Created in 1988 following national health care reform, SUS was designed on the princi ples of comprehensive and universal care. The organization of the system is based on Primary Care Districts, which serve families residing in each district of the city. Each Primary Care District is responsible for 2,000 people and is made up of nurses, doctors, nursing techni cians, dentists and health assistants.

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CMSA TODAY

Issue 4 • 2021