The effects of outcome-based critical pathways in home care on post-home care health resource use and patient satisfaction
Van Dyck, Lisa K.
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In response to the influx of managed care, home care agencies are implementing strategies that promote quality and cost-effective care. Using Orem’s Self-Care Model, this pilot study examined the effects of an outcome-based critical pathway methodology versus traditional problem-oriented nursing care plans on patients' health care resource use and patient satisfaction following home care services. Health care resource use included incidences of hospitalizations, ER use, and unplanned physician office visits. Satisfaction was measured using the Client Satisfaction Questionnaire (CSQ-8). A longitudinal quasi-experimental design was used with a convenience sample of 26 home care patients aged 65 years or older with chronic cardiac conditions. Data collection included telephone surveys, a mailed satisfaction survey and chart reviews. Descriptive statistics, t-tests, chi-squared, and z-tests were used to analyze the data. Findings showed no significant differences between groups for the sample demographics or the dependent variables, health care use and patient satisfaction.