Scarce health care resources require CMs to focus efforts on compliance.

Scarce health care resources require CMs to focus efforts on compliance

Experts share possible solutions to classic problem

As the purse strings controlling the allocation of health care dollars draw ever tighter, case managers have a greater responsibility to improve their patients' compliance with treatment plans. Faced with the ethical dilemma of fairly allocating scarce health care resources, national experts gathered recently at the First International Symposium on Transplant Recipient Compliance in Arlington, VA. The symposium was sponsored by the division of continuing medical education of the University of Alabama School of Medicine in Birmingham. If you aren't familiar with the prevalence of noncompliance among American patients, here are a few facts:

* Patients with chronic conditions with few or no symptoms are most likely to be noncompliant.

* Noncompliant transplant patients were readmitted to the hospital 5.9 times, compared with 2.5 times for compliant patients.

* Several studies show 15% to 18% of kidney transplant patients are noncom pliant, and 91% of noncompliant patients lose their grafts or die from medical complications.

* About 50% of prescriptions written in the United Sates are taken improperly. (For selected resources on compliance, see p. 95.)

"I heard a physician admit once that it took …