Statistical and methodological issues in the evaluation of case management studies

J Healthc Qual. 1996 Nov-Dec;18(6):25-7, 30-1, 41. doi: 10.1111/j.1945-1474.1996.tb00867.x.

Abstract

For the past 3 years, the nursing case management team at North Shore University Hospital in Manhasset, NY, has been involved in a project to implement more than 50 clinical pathways, which provide a written "time line" for clinical events that should occur during a patient's hospital stay. A major objective of this project was to evaluate the efficacy of these pathways with respect to a number of important outcomes, such as length of stay, hospital costs, quality of patient care, and nursing and patient satisfaction. This article discusses several statistics-related issues in the design and evaluation of such case management studies. In particular, the role of a research approach in implementing and evaluating hospital programs, the choice of a comparison (control) group, the exclusion of selected patients from analysis, and the problems of equating pathways with diagnosis-related groups are addressed.

MeSH terms

  • Case Management / organization & administration
  • Case Management / standards*
  • Case Management / statistics & numerical data
  • Critical Pathways*
  • Data Collection
  • Diagnosis-Related Groups
  • Hospitals, University / organization & administration
  • Humans
  • Length of Stay
  • New York
  • Nursing Service, Hospital / standards*
  • Outcome Assessment, Health Care
  • Pilot Projects
  • Program Evaluation
  • Software Design