AJCC
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

American Journal of Critical Care. 2007;16: 447-457
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in AJCC
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Douglas, S. L.
Right arrow Articles by Montenegro, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Douglas, S. L.
Right arrow Articles by Montenegro, H.

Chronically Critically Ill Patients: Health-Related Quality of Life and Resource Use After a Disease Management Intervention

By Sara L. Douglas, RN, PhD, Barbara J. Daly, RN, PhD, Carol Genet Kelley, RN, PhD, Elizabeth O’Toole, MD and Hugo Montenegro, MD. Sara L. Douglas is an associate professor, Barbara J. Daly is a professor, Carol Genet Kelley is an assistant professor, and Elizabeth O’Toole and Hugo Montenegro are professors at Case Western Reserve University, Cleveland, Ohio.

Corresponding author: Sara L. Douglas, RN, PhD, School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4904 (e-mail: SLD4{at}case.edu).

Background Chronically critically ill patients often have high costs of care and poor outcomes and thus might benefit from a disease management program.

Objectives To evaluate how adding a disease management program to the usual care system affects outcomes after discharge from the hospital (mortality, health-related quality of life, resource use) in chronically critically ill patients.

Methods In a prospective experimental design, 335 intensive care patients who received more than 3 days of mechanical ventilation at a university medical center were recruited. For 8 weeks after discharge, advanced practice nurses provided an intervention that focused on case management and interdisciplinary communication to patients in the experimental group.

Results A total of 74.0% of the patients survived and completed the study. Significant predictors of death were age (P = .001), duration of mechanical ventilation (P = .001), and history of diabetes (P = .04). The disease management program did not have a significant impact on health-related quality of life; however, a greater percentage of patients in the experimental group than in the control group had "improved" physical health-related quality of life at the end of the intervention period (P = .02). The only significant effect of the intervention was a reduction in the number of days of hospital readmission and thus a reduction in charges associated with readmission.

Conclusion The intervention was not associated with significant changes in any outcomes other than duration of readmission, but the supportive care coordination program could be provided without increasing overall charges.


Related articles in AJCC:

Clinical Pearls
Mary Jo Grap
AJCC 2007 16: 432. [Full Text]  





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American Association of Critical-Care Nurses.