REPLY
Case Management after Acute Myocardial Infarction
Robert F. DeBusk, MD;
Nancy Houston Miller, RN, BSN; and
C. Barr Taylor, MD
1 November 1994 | Volume 121 Issue 9 | Page 720
IN RESPONSE:
We appreciate and agree with the comments of Drs. Alderman and Shenson regarding the complementary nature of nurse case management for prevention and physician management for acute illness. In our study, the nurse case-management system provided better preventive care than physicians provided alone. However, the authors interpreted our study as suggesting that the preventive care provided in this managed care organization was "wanting." We disagree with this interpretation. The Kaiser-Permanente Medical Care Program has recognized the value of the improved care provided by the nurse case managers. Nurse case management has been incorporated into the routine preventive care provided to patients with ischemic heart disease in 10 Kaiser-Permanente hospitals in northern California, with plans for future expansion to more hospitals.
Our nurse case-management system was developed in response to the fact that management of acute illness leaves physicians little time for direct involvement in preventive care. Incorporating prevention and rehabilitation into medical practice necessitates a complementary approach that uses both physicians and nurses to address the aspects of care for which they are best suited.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Article
