title: Linking quality and cost effectiveness: case management by an advanced practice nurse.
abstract: 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.
authors.forename: T A
authors.initials: TA
authors.lastname: Micheels
authors.forename: L M
authors.initials: LM
authors.lastname: Wheeler
authors.forename: B J
authors.initials: BJ
authors.lastname: Hays
mesh_terms: 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