Implementation of a clinical pathway decreases length of stay and cost for bowel resection
Implementation of a clinical pathway decreases length of stay and cost for bowel resection
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DOI：
10.1097/00000658-199911000-00017
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发表时间：
1999-11-01
影响因子：
9
通讯作者：
Fischer, JE
中科院分区：
文献类型：
--
作者：
Pritts, TA;Nussbaum, MS;Fischer, JE
目的探讨临床路径对小肠和大肠切除术的成本和住院时间的影响。摘要背景数据临床路径的目的是简化患者的护理服务，并在最大限度地降低成本的同时提高效率。从理论上讲，他们应该是最有效的，在共同执行的程序，其中体积和熟悉度是high.MethodsA临床路径，以协助在肠切除术的患者的管理，由一个多学科的团队开发和实施。收集路径实施前1年和实施后1年接受肠切除术的所有患者的住院时间和费用数据。比较了三组：在路径实施前一年接受肠切除术的患者（路径前），路径实施后一年但未纳入路径的患者结果预路径组患者每次住院的平均费用为19997.35 +/- 1244.61美元，预路径组患者为20美元，非通路组为835.28 ± 2286.26美元，通路组为13908.53 ± 1113.01美元（p < 0.05 vs，其他组）。平均术后住院时间为9.98 +/- 0.62天（prepathway），9.88 +/- 0.88天（nonpathway），7.71 +/- 0.37天（pathway）（p < 0.05 vs. other groups）.ConclusionsImplementation of the pathway produced significant decreases in the length of stay and cost in the pathway group as followed by the prepathway group。这些结果支持进一步开发普通外科手术的临床路径。
ObjectiveTo examine the effect of a clinical pathway for small and large bowel resection on cost and length of hospital stay.Summary Background DataClinical pathways are designed to streamline patient care delivery and maximize efficiency while minimizing cost. Theoretically, they should be most effective in commonly performed procedures, in which volume and familiarity are high.MethodsA clinical pathway to assist in the management of patients undergoing bowel resection was developed by a multidisciplinary team and implemented. Data about length of stay and cost was collected for all patients undergoing bowel resection 1 year before and 1 year after pathway implementation. Three groups were compared: patients undergoing bowel resection in the year prior to pathway implementation (prepathway), patients in the year after pathway implementation but not included on the pathway (nonpathway), and patients included in the pathway (pathway).ResultsThe mean cost per hospital stay was $19,997.35 +/- 1244.61 for patients in the prepathway group, $20,835.28 +/- 2286.26 for those in the nonpathway group, and $13,908.53 +/- 1113.01 for those in the pathway group (p < 0.05 vs, other groups). Mean postoperative length of stay was 9.98 +/- 0.62 days (prepathway), 9.88 +/- 0.88 days for (nonpathway), and 7.71 +/- 0.37 days (pathway) (p < 0.05 vs. other groups).ConclusionsImplementation of the pathway produced significant decreases in length of stay and cost in the pathway group as compared to the prepathway group. These results support the further development of clinical pathways for general surgical procedures.