Case management for at-risk elderly patients: a review

In Hong Kong, elderly patients recently discharged from hospital are at high risk of unplanned readmission, leading to the phenomenon of the ‘revolving door syndrome’. A review of the literature and also studies conducted locally suggest that a case management approach could be a useful tool to achieve a more coordinated and better continuum of care for this group of patients. The case management tool could also contribute to a more integrated care system for the frail elderly, due to pooling of expertise and resources from the health and long-term care sectors. More studies should be encouraged locally to explore a broader application of this approach as a means of improving elderly care for the rapidly ageing population of Hong Kong.