The Impact of Case Management on Reducing Readmissions for Patients Diagnosed with Heart Failure and Diabetes
McCants, Khalilah, Nursing Practice - School of Nursing, University of Virginia
Reid, PhD, RN, FNP-C, Kathryn, School of Nursing, University of Virginia
Purpose of the study: To determine the impact of case management services versus treatment as usual (TAU) for patients diagnosed with diabetes and concomitant heart failure.
Research Question: When patients, those diagnosed with diabetes and heart failure who receive case management services, are discharged from an acute level of care, do they have lower rates of 30-day readmissions than patients who receive treatment as usual (TAU)?
Methods: A retrospective, descriptive, comparative analysis was conducted at a single-site facility of case management services compared to treatment as usual (TAU) from a medical chart review of 68 patients beginning September 1, 2015 through July 31, 2017.
Procedures: A medical chart review was conducted to generate the study sample for data collection and analysis. The data was organized, cleaned, and prepared then analyzed.
Data Analysis: The data was analyzed using SPSS and verified with SAS and R. Applied were descriptive statistics and statistical tests - T-Test, Chi-square, Mann-Whitney U, and Logistic Regression.
Results: For the case management group, there were 18.4% who readmitted while 81.6% did not. For the treatment as usual group, there were 52.6% who readmitted and 47.4% who did not. The association between readmissions and case management was χ2 (1,n= 68) = 6.372, p = .012.
Nursing implications: Case management services were statistically significant in reducing readmissions for the sample. Demographics tested in this study were not significant predictors for readmissions. Extending length of stay for patients who are not medically ready for discharge should be considered since there is a cost difference, as there is evidence of readmission reduction. Policy and procedural amendments can be obtained from this study.
DNP (Doctor of Nursing Practice)
case management, heart failure, diabetes, quality improvement, readmission
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