DESCRIPTIVE STUDY OF MODELS OF DISCHARGE PLANNING AND CASE MANAGEMENT IN CALIFORNIA (ACUTE CARE HOSPITALS).
Contributors: University of California, San Francisco.
Published: 1991
Number of pages: 259
Subjects: Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: Acute care hospitals in California that had medical/surgical services as the primary patient service were surveyed to identify and describe the type of discharge planning services that were offered. Hospital discharge planning services were classified into traditional discharge planning (TDP), expanded discharge planning (EDP), and case management (CM) services. TDP was defined as discharge planning services that ended at the time of patient discharge from the hospital. EDP was defined as contact with the patient by hospital staff for up to two weeks following discharge. CM was defined as ongoing patient contact for longer than two weeks following hospital discharge.

Of the 417 California hospitals eligible for inclusion in the study, 209 participated in the survey by completion of the mailed survey. The mean hospital size was 226 beds. Profit hospitals were under represented among the responding hospital sample. There were 872 discharge planners, 52% of which were nurses.

Sixty-eight hospitals offered EDP services, and were included in a follow-up telephone survey. The mean size of the hospitals with EDP services was 193 beds. The EDP hospitals tended to be non-profit, larger hospitals, located in greater numbers in Central or Southern California. Seventy-percent of the staff in the EDP programs were discharge planners or social workers. Thirty-five percent of the hospitals contacted the patients to evaluate if the discharge plan was adequate, and to intervene if necessary.

Eleven hospitals offered CM services. These hospitals were included in a follow-up telephone survey. The mean size of the CM hospitals was 484 beds. No profit hospitals were identified as offering CM programs. Of the 94 case managers employed in the 11 hospitals, 25% were nurses, and 75% were non-nurses. The perceived benefits of the CM programs included to: (1) decrease hospital readmissions; (2) promote independent living for elderly living at home; (3) improve the quality of patient care/outcomes; (4) provide a community service; (5) decrease the inappropriate use of the Emergency Department; and (6) provide patient advocacy. A lack of outcome measurement among the CM programs precluded validation of the program benefits.
Notes: Source: Dissertation Abstracts International, Volume: 52-07, Section: B, page: 3529.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1991.

School code: 0034.