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Related Experiment Videos

The integrated inpatient management model. Lessons for managed care

A M Bernard1, R A Hayward, J E Anderson

  • 1Department of Internal Medicine, University of Michigan Hospitals, Ann Arbor, USA.

Medical Care
|July 1, 1995
PubMed
Summary

The Integrated Inpatient Management Model, using a clinical information system, significantly reduced hospital length of stay (LOS) for general medicine services. This innovative approach also decreased preventable deaths, demonstrating potential for managed care systems.

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Area of Science:

  • Health Services Research
  • Clinical Informatics
  • Hospital Administration

Background:

  • The need for efficient hospital management and resource utilization is critical in healthcare.
  • Clinical information systems offer potential solutions for optimizing patient care pathways.
  • Previous studies highlighted variability in inpatient care practices.

Purpose of the Study:

  • To evaluate the impact of the Integrated Inpatient Management Model on hospital length of stay (LOS).
  • To assess the effect of a clinical information system on physician and hospital practice.
  • To determine the influence of the model on resource utilization and patient outcomes.

Main Methods:

  • A 2.5-year controlled prospective trial involving over 2,000 admissions.

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  • Implementation of a clinical information system on general medicine services at a university hospital.
  • Comparison of an intervention service utilizing the system against a control service and historic norms.

    • Main Results:

    • Mean LOS decreased significantly for both control (0.68 days) and intervention (0.95 days) services compared to historic norms (P < 0.01).
    • The intervention service showed a trend towards fewer LOS outliers (P = 0.14) and a reduction in preventable deaths (P = 0.04).
    • Ancillary service use decreased by 17% on both services during the study, contrasting with a 29% increase elsewhere.

    Conclusions:

    • The Integrated Inpatient Management Model, driven by a clinical information system, effectively reduced hospital LOS and preventable deaths.
    • This model serves as a prototype for systems essential for the future of managed care.
    • While resource use and quality metrics showed mixed results, the system demonstrated significant improvements in specific areas.