Document Detail

Long-term outcome following case management after coronary artery bypass surgery.
MedLine Citation:
PMID:  10063958     Owner:  NLM     Status:  MEDLINE    
Patient outcome following coronary artery bypass grafting (CABG) has come under increasing governmental, social, and economic scrutiny. To insure quality patient outcome after CABG, many new policies and programs have been instituted. One of these, case management, was developed as a tool for identification and quantification of patient clinical sequences and resource utilization. This present study examines the influence of case management on length of stay and patient outcome following CABG. One hundred forty randomized, retrospectively analyzed CABG patients from 1990, prior to case management, were compared against 140 age-and case-matched randomly controlled CABG patients from 1994 after case management was in place. Patients' demographics were similar. The outcome data showed that intensive care unit (ICU) use and total length of stay were significantly decreased. Furthermore, resource utilization as monitored by chest X-ray, electrocardiography, and laboratory testing were decreased as well. Finally, mortality was decreased despite an increase in risk-adjusted acuity of the patients. There appeared to be no effect of gender or age on the benefit derived from case management. These data demonstrate that the influence of case management is beneficial for resource utilization and patient outcome following CABG and that these types of patient care policy advancements should be encouraged.
J Walters; C F Schwartz; H Monaghan; J Watts; G J Shlafer; G M Deeb; S F Bolling
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  13     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1999-04-22     Completed Date:  1999-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  123-8     Citation Subset:  IM    
Section of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, USA.
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MeSH Terms
Case Management*
Coronary Artery Bypass / mortality,  statistics & numerical data*
Cost Control
Critical Pathways
Health Resources / utilization
Intensive Care Units / utilization
Length of Stay / statistics & numerical data
Middle Aged
Outcome Assessment (Health Care)*
Random Allocation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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