個案管理師執業範圍的現況與展望

Practice scope of case manager： Implementation and barriers

近二十年來由於醫療費用逐年上升，為減緩其費用上漲之速度，管理式醫療照護（managed care）日益受到重視且蓬勃興盛於21 世紀健康照護系統。然而個案管理為管理式醫療照護中所發展出的新名詞之一，在個案管理照護中個案管理師（case manager）扮演監督、指導及資源使用控制之重要角色，且影響到管理之成功與否。由於護理人員具有醫療及照護專業知識、技巧及熱誠，故被認為最適合擔任個案管理師之職務。目前個案管理照護模式已應用於我國健康照護系統，但護理執業範圍並無明確的規範，期待個案管理師的專業發展，能在進階護理的角色被關注。

Managed care has evolved over the past 10 to 20 years due to the dramatically rising costof health care. Hence, the health care delivery system of the 21st century has put emphasis onmanaged care and incorporated it into case management. Case management is a system ofdelivering patient care that focuses on improving the quality of service, utilizing resources andcontrolling health costs. Thus, the role of case managers has become a key position tosuccessfully implement case management. Nurses make excellent case managers in a diseasemanagement program by virtue of their rich clinical skills, knowledge and their regular Interactions with patients and other health care providers. Case management is a new nursingpractice in Taiwan, and currently lacks preparation and standardization for practicingcompetencies; however, we look forward to the development and incorporation of theprofession of case managers into advanced nursing practice as well as the recognition of theimportance of such a role within the health care system.