Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care

Purpose To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research. Organizing Construct The Quality Cost Model of APN Transitional Care. Methods Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care. Findings APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group. Conclusions To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost

Statistical Methods for Health Care Research

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Statistical Methods for Health Care Research third edition

The purpose of the first edition of Statistcal Methods for Health Care Research Was to acquaint the reader with the statistical techniques most commonly reported in the research literatur of the health professions. In the second edition, We further reduced mathematical equations, moved from mainframe to personal computer examples, and added new techniques such as logistic regression. In this third edition, we continue to strive to present complex statistical techniques in the most understandable way possible. We continue to underplay the role of mathematical calculations, assuming that readers will be using a personal computer for statistical analyses.x + 444 hlm ; 25 x 19,5 c