Long-term outcome following case management after coronary artery bypass surgery

Patient outcome following coronary artery bypass grafting (CABG) has come u nder increasing governmental, social, and economic scrutiny. To insure qual ity patient outcome after CABG, many new policies and programs have been in stituted. One of these, case management, was developed as a tool for identi fication and quantification of patient clinical sequences and resource util ization. This present study examines the influence of case management on le ngth of stay and patient outcome following CABG. One hundred forty randomiz ed, retrospectively analyzed CABG patients from 1990, prior to case managem ent, were compared against 140 age-and case-matched randomly controlled CAB G patients from 1994 after case management was in place. Patients' demograp hics were similar. The outcome data showed that intensive care unit (ICU) u se and total length of stay were significantly decreased. Furthermore, reso urce utilization as monitored by chest X-ray, electrocardiography, and labo ratory testing were decreased as well. Finally, mortality was decreased des pite an increase in risk-adjusted acuity of the patients. There appeared to be no effect of gender or age on the benefit derived from case management. These data demonstrate that the influence of case management is beneficial for resource utilization and patient outcome following CABG and that these types of patient care policy advancements should be encouraged.