EXPLANATION OF HOSPITAL STAY BY NURSING DIAGNOSES, MEDICAL DIAGNOSES, AND SOCIAL POSITION.
Contributors: Case Western Reserve University.
Published: 1986
Number of pages: 215
Subjects: Health Sciences, Nursing.
Description: Length of stay is of critical interest because it is considered a measure of hospital resource consumption. The shift in payment method from cost reimbursement to prospective payment intensified health care managers' interest in achieving cost-effective lengths of stay. This study described the amount of variation in length of stay explained by: (a) 127 nursing diagnoses recorded daily on the Nurse/Patient Summary, a measure of patients' dependence on nurses; (b) 288 diagnosis related groups (DRGs) assigned at discharge, a measure of medical illness; and (c) 8 demographic descriptors used as a measure of social and economic status (social position). The study was a secondary analysis of a convenience sample of 1,255 medical/surgical patients at a university hospital. The sample included 661 women and 594 men ranging in age from 16 to 97 years. Results indicated variation in stay was better explained by patients' nursing diagnoses than by either their medical diagnoses or their social position. The stepwise linear regression model explained 71.48% of the variation in stay with 59.98% attributed to the partial contributions made to the explanation by nursing diagnoses, an additional 11.12% attributed to the partial contributions of medical diagnoses, and .38% attributed to the partial contributions of social position descriptors. The data suggest that nurses have potential to optimize lengths of stay by facilitating patients' progress toward independence from nursing care. Since stay was best explained by presence or absence of patient dependency needs (nursing diagnoses) that are managed by nurses, the decisions about where nursing care is provided during and following hospitalization could be managed by nurses.
Notes: Source: Dissertation Abstracts International, Volume: 47-07, Section: B, page: 2840.

Thesis (PH.D.)--CASE WESTERN RESERVE UNIVERSITY, 1986.

School code: 0042.