MEASURING CASE-MANAGEMENT FOR FAMILIES WITH HIV

Case management has been recognized as a major way for coordinating th e multiple services needs for people with HIV/AIDS. Such coordination is required because of the progressively debilitating nature of this c hronic disease and the fragmented health care and social services deli very system. One of the major problems with the study of case manageme nt is the difficulty in actually measuring it. Another major limitatio n has been the focus almost exclusively on adult models of HIV/AIDS ca se management. This study was undertaken to assess the efficacy of a t ime study methodology to measure differences in case management activi ties when case managers work with families and when they work with ind ividuals. Ten case managers from two urban hospital pediatric and adul t HIV/AIDS clinics and 10 case managers from 3 community organizations participated. Case management activity was sampled using a beeper car ried by case managers which signaled randomly 8 times a day over 5 con secutive days. When the signal ''beeped,'' case managers checked off o n a 1-page form the appropriate descriptor of their involvement concer ning task initiation, interaction, location, type, function as well as information about client needs, HIV status, and family history. The r esults suggest that the Time Study methodology is a useful and valid w ay of measuring case management and of identifying differences in case mix, client need and background, and case management techniques when case managers work with families and with individuals.