HOSPITAL BASED MANAGED CARE: COST AND QUALITY

基于医院的管理式医疗：成本和质量

• 批准号: 3427663
• 负责人: MARY A. BLEGEN
• 金额: $ 7.25万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-30 至 1994-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3427663
• 关键词: diagnosis quality /standard; health care; health care cost /financing; health care personnel education; health care quality; health care service evaluation; hospital length of stay; patient care management; satisfaction

Managed care, used for many years to increase efficiency in primary health services, is proposed as a way of increasing efficiency in hospital care. This Hospital Based Managed Care (HBMC) intervention is designed to increase efficiency by eliminating redundant patient care components while maintaining effectiveness of care and patient satisfaction with care. The HBMC intervention consists of a multi- disciplinary CareMap(tm) that includes key care components and patient problems common to a specific group of patients, i.e. diagnostic group, and a Nurse Case Manager. The Nurse Case Manager coordinates a multi- disciplinary team that develops the CareMap(tm), supervises the implementation of the map, provides staff education, and monitors patient progress. This research project is a pilot test of HBMC with C-section patients, preparatory to implementing and testing HBMC throughout the institution. The population used for the pilot test will be all patients with C-section, the most commonly performed surgery in the US. A cohort study, with quasi-comparable groups (N=200), will be used to determine the effects of the intervention on the length of stay, costs, patient outcomes, and satisfaction. HBMC will be implemented on July 1, 1992, and two months will be allowed for all staff to alter their practice to conform with the map. The groups that will be compared are a control group, patients having C-sections from January, 1992, through June, 1992; and an experimental group, patients having C-section from September, 1992 through March, 1993. The procedures for training nurse case managers, developing and implementing CareMaps(tm), and assessing the variance from the map will also be evaluated.

管理式护理，多年来用于提高初级保健的效率 卫生服务被提议作为提高效率的一种方式 医院护理。 这种基于医院的管理式护理 (HBMC) 干预措施是 旨在通过消除多余的患者护理来提高效率 组件，同时保持护理和患者的有效性 对护理的满意度。 HBMC 干预包括多种 纪律 CareMap(tm)，包括关键护理组成部分和患者 特定患者组（即诊断组）常见的问题， 和一名护士个案经理。 护士案例经理协调多方 开发 CareMap(tm) 的纪律小组，监督 实施地图、提供员工教育并监测患者 进步。 本研究项目是剖腹产 HBMC 的先导试验 患者，准备在整个过程中实施和测试 HBMC 机构。 用于试点测试的人群将是所有患有以下疾病的患者 剖腹产是美国最常进行的手术。 一个队列 具有准可比组（N = 200）的研究将用于确定 干预措施对住院时间、费用、患者的影响 结果和满意度。 HBMC将于1992年7月1日实施， 所有员工将有两个月的时间改变他们的做法 与地图相符。 将进行比较的组是对照组 组，从1992年1月到1992年6月进行剖腹产的患者； 实验组是1992年9月进行剖腹产的患者 到 1993 年 3 月。培训护士个案管理人员的程序， 开发和实施 CareMaps(tm)，并评估与 地图也将被评估。