Effects of Case Management in Trauma Patients in Taiwan: A Randomized, Longitudinal Study

Abstract

Background: Case management can improve trauma patient outcomes from the acute to rehabilitation phases. However, a lack of evidence on the effects of case management in trauma patients makes it difficult to translate research findings into clinical practice. Objective: To examine the effects of case management on illness perception, coping strategies, and quality of life in trauma patients followed up to 9 months post-hospital discharge. Methods: A four-wave longitudinal experimental design was used. Patients with traumatic injury hospitalized at a regional hospital in southern Taiwan from 2019 to 2020 were randomly assigned to a case management (experimental) or a usual care (control) group. The intervention was implemented during hospitalization with a phone call follow-up about 2 weeks post-discharge. Illness perception, coping strategies, and health-related quality-of-life perceptions were measured at baseline, 3 months, 6 months, and 9 months after discharge. Generalized estimating equations were used for analysis. Results: Findings showed a significant difference in illness perception at 3 and 6 months and coping strategies used at 6 and 9 months after discharge between the two groups. No significant difference in the quality of life over time between the two groups was found. Conclusion: Although case management appears to help patients with traumatic injuries decrease illness perception and better cope with their injury, it did not significantly improve their quality of life 9 months after discharge. It is recommended that health care professionals develop long-term case management strategies for high-risk trauma patients.