Evaluation of perinatal care management programs: an integrated review

Nursing care management has become a popular method to integrate health care systems with goals of decreasing costs and improving quality. As high-risk pregnancies and newborn intensive care unit (NBICU) costs generate some of the highest costs in health care, care management has been a strategy introduced in perinatal medicine to accomplish the same goals. Consistent with other areas of nursing, perinatal care management currently has no agreed upon model of practice or method of evaluating how and whether the goals have been achieved. The purpose of this project was to evaluate various perinatal care management programs found in the literature. Electronic and manual searches of current data were performed locating 31 relevant articles. From these articles, nine met the inclusion criteria and were reviewed. While some care management programs were able to decrease costs and improve outcomes, other programs did not. There are possibly two reasons for the varied results in the literature. The first is that there are differences in program designs, decreasing the likelihood of identifying specific interventions that can make a difference. Second, thus far researchers have used ineffective study designs in evaluating care management programs. More research needs to be completed before a conclusion can be drawn whether perinatal care management can decrease costs while improving quality.