Nurse case management and hospital length of stay

Abstract

The relationship between hospital length of stay (LOS) and Nurse Case Management (NCM), defined as the coordination of care along a continuum of hospital and community, was investigated. Three groups of discharged patients in the Diagnostic Related Groups (DRGs) of the Respiratory and Circulatory Medical Diagnostic Categories (MDCs) were described and compared: those who had NCM pre-hospitalization (n = 43), those who had NCM initiated during hospitalization or shortly afterward (n = 22), and those who had no NCM (n = 50). The NCM pre-hospitalization group was older and more likely to live alone. The non-NCM group had more admissions to Critical care. The NCM pre-hospitalization group entered the hospital with lower acuities. The NCM initiated during hospitalization group had significantly higher LOS than the other two groups. There was no significant relationship between LOS and the number and duration of NCM visits. The findings suggest that (1) NCM subjects were at higher risk due to age and living situation and (2) NCM may be associated with reduced LOS on subsequent admissions.