The central role of case managers in early discharge planning for hospitalized persons with AIDS

Case managers can play a pivotal role in the hospital discharge planning process for medically complex patients. This is particularly true for persons with AIDS. This prospective study quantifies the importance of this role by examining the ability of case managers, nurses, and physicians to predict (at the time of admission) whether hospitalized AIDS patients would be appropriate for transfer to long-term care facilities after their hospital stays. We studied 120 AIDS patients and their primary providers; 38 (32%) patients were found to be appropriate for discharge to long-term care facilities at the end of their hospital stays. Physicians and nurses had similar accuracy in predicting eventual appropriateness for long-term care (75% and 73% correct, respectively); however, case managers were far more accurate than the physicians and nurses (93% correct, p < .05). This finding highlights the unique ability of case managers to facilitate discharge planning early on in the hospital stays of these complex patients. In this study, case managers were more accurate than physicians or nurses in predicting appropriateness for long-term care of hospitalized persons with AIDS. Case managers should play an integral role in coordinating discharge planning of persons with AIDS; this planning should be part of the hospital admission process.