OUTCOME MEASURES OF MANAGED CARE IN AN INTENSIVE CARE NURSERY (NEONATAL).
Contributors: University of Florida.
Published: 1994
Number of pages: 206
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: The objective of this research was to determine the outcomes of a managed care clinical system (MCCS) in one intensive care nursery in Central Florida. The population was composed of neonates, parents, health care team, and professional nurses. The outcome variables measured were length of stay, number of feeding days from start of nipple feeding to total nipple feeding and from admission to total nipple feeding, rate of readmissions, parent satisfaction with this MCCS, professional nurse and health care team work satisfaction, and costs of neonatal care to the institution.

A randomized research design was used. Roy's Adaptation Model for Administration (RAMA) served as the organizing framework. Outcome measures were obtained for seven months in the conventional system (CS) and for seven months after the MCCS had been implemented. There were 260 neonates enrolled in the study, 111 (55.8%) in the CS and 149 (52.8%) in the MCCS, who met the criterion of being in Diagnosis Related Group (DRG) 386 or 387 during the data collection period. Nine parents in the CS and 96 parents participated under the MCCS. Sixty-four health care team members completed the Health Care Team Questionnaire (HCTQ) in the CS and 69 health care team members participated under the MCCS.

Analysis of variance, t-tests, and chi-squared tests were the statistical analyses used to test the eight hypotheses. In the MCCS, neonates in DRG 386 had a shorter mean length of stay, increased frequency of complications, and higher mean daily costs than neonates in the CS. In contrast, neonates in DRG 387 had a longer mean length of stay and lower mean daily costs than neonates in the CS. Nursing care costs remained relatively constant despite increased neonatal complications. Parent, professional nurse, and health care team satisfaction did not change significantly from the CS to the MCCS.

One major outcome was concluded from this study: an investigator can evaluate the outcomes of this system in a dynamic neonatal setting. A major health policy need was identified to reclassify the DRG system to more clearly delineate resource consumption by developmental age instead of by diagnostic related groups.
Notes: Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6035.

Thesis (PH.D.)--UNIVERSITY OF FLORIDA, 1994.

School code: 0070.