Linking quality and cost effectiveness: case management by an advanced practice nurse.
This retrospective chart review examined relationships among case management by an advanced practice nurse (APN), patient acuity, and length of hospital stay among 35 case-managed and 43 non-case-managed patients with colon resection. Patients case managed by the APN had a mean (+/- SD) acuity level of 8.36 +/- 3.98 and mean length of stay (LOS) of 11.51 +/- 4.28 days; non-case-managed patients had a mean acuity of 7.78 +/- 3.55 and mean LOS of 12.35 +/- 7.30 days. These differences were not statistically significant. In separate group regressions, acuity significantly predicted LOS for the non-case-managed group (R2 = 0.137, p = 0.0145) but not for the case-managed group (R2 = 0.0351, p = 0.2812). APN case-managed patients showed a trend toward higher acuity and shorter LOS. It appears that APN involvement in care negated acuity as a predictor of LOS. Patterns of association between APN case management and patient outcomes warrant further investigation.
Micheels
T A
TA
Wheeler
L M
LM
Hays
B J
BJ
D003108:Colonic Diseases / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D008875:Middle Aged; D009720:Nurse Clinicians / Q000592:standards*; D011787:Quality of Health Care; D012189:Retrospective Studies