Abstract
Purpose. The purpose of the study was to determine cost and quality impacts of the patient-focused care (PFC) delivery system implementation and operation in an acute care hospital. Methodology. The study utilized an interrupted time-series design with four replications that covered a period of time from 1990-1994. The mean values for total direct labor and direct non-labor cost per case by unit and DRG, length of stay by unit and DRG, medication error rate, patient fall rate, and patient satisfaction were tested through the use of the t-test to determine if there were significant differences in the mean values before and after implementation of the PFC delivery system. The interrupted time-series design allowed for an analysis of the mean trend directions for the outcome variables before and after intervention. Findings. Results of the study suggest there is a difference before and after implementation for selected cost and quality outcome indicators. The findings of the study did not directly support the assumption that PFC delivery system restructuring will result in a reduction of total direct labor and direct non-labor costs per case. There were improvements in the mean length of stay, medication error rate, and patient fall rate, but the differences were not significant at the 0.05 probability level of significance. The major finding of the study was that a significant difference existed between before and after intervention mean patient satisfaction ratings. Conclusions and recommendations. Whether PFC delivery system restructuring will fulfill all its intended outcomes remains to be seen. The true results of PFC systems restructuring may not become evident until restructuring has been accomplished hospital wide. In the event cost per case reductions are not significant, hospitals will need to ask themselves whether or not improvements in the patient's perceptions of the hospital experiences are worth pursuing even though cost per case may remain the same.