한국 의료급여 사례관리 개입 효과와 남아있는 과제 주제범위 문헌고찰 = Effectiveness and Remaining Challenges of Case Management Interventions for Medical Aid in Korea: A Scoping Review

다국어 초록 (Multilingual Abstract)

-Purpose:This study aims to review research on case management interventions targeting Medical Aid beneficiaries, investigate the evidence of their effectiveness, identify reported issues, and derive implications for future development.
-Methods:A scoping review was conducted using the Arksey and O'Malley’s framework. Literature was retrieved from Korean (RISS, KISS, DBpia, Science On, NAL), and the search terms used were “Medical Aid” AND “case management”. The international databases were PubMed and Web of Science, and the search terms were “Medical Aid” AND “case management” AND “Korea”. The search period was limited from 2003 to 2024.
Eligibility Criteria:We reviewed all studies involving case management for Medical Aid beneficiaries, including types of interventions, intervention effects, beneficiary characteristics, issues, and suggestions. For the review of the effectiveness of case management, only studies reporting the impact of case management interventions on patient behaviors, medical utilization, and medical costs were included.
-Results:A total of 46 academic papers and dissertations on Medical Aid case management were included in the review. Of these, 15 studies specifically focused on evaluating the effects of case management interventions. The selected studies were analyzed and summarized based on their research methods, study population, types of interventions, intervention outcomes, data sources, challenges, and recommendations.
-Conclusion:Effective case management requires tailoring to the severity of illness, age, and regional characteristics. Studies highlight the need to adjust intervention methods, duration, and frequency based on case management goals and beneficiary needs. Long-term strategies are essential for beneficiaries, such as mental health patients, who don’t show immediate effects. Success hinges on collaboration with healthcare providers, community integration, and establishing a comprehensive care system, particularly for mental health patients.