EFFECTS OF A NURSING CASE MANAGEMENT MODEL ON PATIENT LENGTH OF STAY AND VARIABLES RELATED TO COST OF CARE DELIVERY WITHIN AN ACUTE CARE SETTING.
Contributors: Columbia University. Teachers College.
Published: 1990
Number of pages: 210
Subjects: Health Sciences, Nursing.
Description: The purpose of this research was to investigate the effects of a nursing case management model on variables related to patient length of stay and the cost of care delivery of patients hospitalized for cesarean section in an acute care setting. A nonrandom selection was employed for both the nursing provider and patient subject population. The sample consisted of 128 patients (768 total patient days) who had surgery by cesarean section. DRGs 370-371 were used.

The study utilized a quasi-experimental design on the experimental and control units. The data needed to meet the objectives of the investigation involved the development and implementation of the nursing case management delivery system with the experimental group. To collect demographic data, length of stay, and related complications, a data collection form was used with the medical record reviews of the patients' subject group. A Nursing Case Management Activity Form was used to determine the average amount of nursing time spent in patient care.

Data were analyzed using a two-tailed t-test for independent samples at the.05 level of significance. Descriptive statistics were performed on all demographic data. A cost analysis using a cost-accounting methodology was also computed retrospectively, taking into account fixed (personnel) and variable (pharmaceuticals, supplies) cost factors. An evaluation was made of staff mix and skill as well as the amount of time needed to administer nursing care to cesarean section patients.

A significant reduction in patient length of stay was achieved (p $\leq$.0001). Length of stay declined by 1.16 days or 19 percent between the experimental and control groups. Expenditure and cost analysis showed an increase in direct nursing care hours and intensification of inpatient services and treatments. This resulted in an overall decrease in length of stay, an increase in patient turnover, and potential savings and revenues of more than $1 million generated for the hospital. The study suggests several implications for nursing practice, nursing administration, and the health care field in general.
Notes: Source: Dissertation Abstracts International, Volume: 51-07, Section: B, page: 3325.

Thesis (ED.D.)--COLUMBIA UNIVERSITY TEACHERS COLLEGE, 1990.

School code: 0055.