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EVALUATION OF THE CLINICAL INTEGRATION MODEL FOR HOSPITAL CARE DELIVERY by CHERYL MCKAY

By: MCKAY, CHERYL [author].
Contributor(s): The University of Texas at Tyler.
Material type: TextTextPublisher: [Tyler, Texas] [University of Texas at Tyler] 2012Description: 1 online resource (v, 77 pages) text file, PDF.Content type: text Media type: computer Carrier type: online resourceSubject(s): Hospital utilization -- Length of stay | Psychiatric hospitals -- Length of stay | Clinical integration | NursingOnline resources: Dissertation Dissertation note: Dissertation (Ph.D.), University of Texas at Tyler, 2012 Summary: 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’s 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.
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Item type Current location Collection Call number URL Status Date due Barcode
UT Tyler Dissertation UT Tyler Online
Online
University Archives & Special Collections RA407.3 .M35 2012 (Browse shelf) http://hdl.handle.net/10950/93 Available 851595220

Dissertation (Ph.D.), University of Texas at Tyler, 2012

Includes bibliographic references (pages 47-51).

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’s 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.

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