Cheryl McKay

Abstract

Purpose: Two studies were used to evaluate whether introduction of the Clinical Integration Model (CIM) would decrease cost, length of stay (LOS), and mortality in two populations: a psychiatric in-patient population and congestive heart failure (CHF) patients. Objectives: 1. Evaluate reliability and validity of a process tool, the CareGraph, essential in the CIM. 2. Determine if there is a difference for LOS and cost between patients receiving care in the CIM and those receiving care in a traditional primary care delivery model in a psychiatric population; compare the same parameters as well as survival in the CHF population. Methods: Reliability of the CareGraph tool was evaluated using Cronbach™s alpha, and known-groups validity was evaluated using a t-test to compare admission and discharge scores. A retrospective pre-implementation, post-implementation design was utilized to evaluate outcomes in the psychiatric population. A retrospective comparative design was used in the CHF population. Results: Initial Cronbach™ alpha for all CareGraph items was .71. For the psychiatric population, LOS increased between 2010 (4 days) and 2011 (5 days) (t [189] = -2.71, p<.01). Although the LOS was longer after implementation of the CIM, the cost was not significantly different. Evaluation of differences between CIM hospitals and regular care hospitals using the inpatient CHF population showed a significant difference in two outcome variables; LOS, F(3, 245) = 5.78, p = .001 and cost F(3,226) = 21.70, p = .000 but no difference in survival rates.

Date of publication

Fall 8-16-2012

Document Type

Dissertation

Language

english

Persistent identifier

http://hdl.handle.net/10950/93

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