Differences Between Case Managed and Non-Case Managed Length of Stay, Cost Effectiveness and Patient Satisfaction

Case management is a process of providing standardized care that focuses on efficient use of resources to enhance the quality and delivery of health care within a specific time frame. Research supports the fact that case management can have an impact on length of stay, cost effectiveness and patient satisfaction. The purpose of this quasi-experimental study was to determine the differences in length of stay in hours, direct cost and patient satisfaction between non-case managed and case managed cardiac catheterization outpatients. A 6-month retrospective convenience sample of 57 non-case managed patients was reviewed for length of stay and direct cost. Recalled patient satisfaction was determined through a telephone survey on a sample of 53 non-case managed patients. A convenience sample of 40 patients over a 4-month period was case managed. Length of stay and direct cost per patient were examined. After informed consent was obtained, Bleegan and Goode\u27s Patient Satisfaction with Quality of Care in the Hospital survey was completed by each of the case managed patients before dismissal. The patient satisfaction responses were compared with the recalled responses of satisfaction and at-test was run to evaluate the differences in satisfaction of case managed and non-case managed patients. Descriptive statistics were used for overall patient satisfaction. Length of stay and costs were also analyzed with attest and with descriptive statistics. A .05 level of significance was established to determine if differences were significant. An ANOV A was used to compare differences between case managed and non-case managed patients in regard to length of stay and cost. Data from the study indicated there was no significant statistical difference in length of stay, direct cost or patient satisfaction between the case managed and the non-case managed group. There was a direct correlation between length of stay and direct cost, but no correlation to patient satisfaction. The data did indicate that case managed patients have a shorter length of stay, decreased direct cost and improved patient satisfaction which the institution found to be appreciable. Through analysis of clinical pathway exceptions, revisions of care can be made to enhance positive outcomes in these three areas. Case management can have an impact on length of stay, direct cost and patient satisfaction. It is the nurse\u27s responsibility to standardize care to eliminate variance and ultimately improve desired outcomes in these important areas