Why Case Management is Not Sufficient Anymore… We Need Care Management

Author: Tessa Windelinckx Stefan Bourgeois Stefan Bratovanov Werner De Keyzer Britt Weygaerts Camille Torfs-Leibman Griet Maertens

Theme: Models of Care Year: 2022

The Antwerp model – a strong cooperation between ZNA (a large community hospital) and NGO
Free Clinic (a low threshold drug service) – has a long history of treating PWUD for hepatitis C.
In the early days of interferon we have treated the most motivated, during the first years of DAA we
treated the sick (F3,F4), and later on the easiest to catch.
Since a few years we’ve noticed that it’s not easy to get people to treatment and link to care as we
are confronted with multiple problems on different levels: social and economic problems, but also
multiple health problems in this very fragile population. We see PWUD with COPD, kidney problems,
heart issues, HCC ….
In order to treat these populations, we see that case management is not enough and these PWUD
need a stronger model of care.
Description of model of care/intervention:
We developed a good practice model of care – based on intensive support, including peer support.
In this ‘care management’, both the hepC nurse and the hepatologist very intensively collaborate
and supervise the medical care management plans, PWUD are supported by the C-Buddy team in
guiding them throughout the different medical treatments. This approach has proven his efficacy in
different cases.
Next to the medical ‘care plan’, there is also a need for a social and financial approach and planning.
Intensive collaboration and interaction with different social services, financial services, drug services
is organized.
Conclusion and next steps:
We will present our most recent data on this phenomenon and with some case studies illustrate
‘Care management’ as ‘Case management 2.0’.
Disclosure of Interest Statement:

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