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  1. Impact of clinical pathways on hospital costs and early outcome after major vascular surgery. Discussion.

    Article - En anglais

    Purpose 

    The purpose of this study was to determine whether major vascular surgery could be performed safely and with significant hospital cost savings by decreasing length of stay and implementation of vascular clinical pathways.

    Methods 

    Morbidity, mortality, readmission rates, same-day admissions, length of stay, and hospital costs were compared between patients who were electively admitted between September 1,1992, and August 30,1993 (group 1), and January 1 to December 31,1994 (group 2), for extracranial, infrarenal abdominal aortic, and lower extremity arterial surgery.

    For group 2 patients, vascular critical pathways were instituted, a dedicated vascular ward was established, and outpatient preoperative arteriography and anesthesiology-cardiology evaluations were performed.

    Length-of-stay goals were 1 day for extracranial, 5 days for aortic, and 2 to 5 days for lower extremity surgery.

    Emergency admissions, inpatients referred for vascular surgery, patients transferred from other hospitals, and patients who required prolonged preoperative treatment were excluded.

    Results 

    With this strategy same-day admissions were significantly increased (80% [145/177] vs 6.2% [9/145]) (p<0.0001), and average length of stay was significantly decreased (3.8 vs 8.8 days) (p<0.0001) in group 2 versus group 1, respectively.

    There were no significant differences between group 1 and group 2 in terms of overall mortality rate (2.1% [3/145] vs 2.3% [4/177]), cardiac (3....

    Mots-clés Pascal : Chirurgie, Aorte abdominale, Artère, Membre inférieur, Délai, Hospitalisation, Coût, Mortalité, Morbidité, Homme

    Mots-clés Pascal anglais : Surgery, Abdominal aorta, Artery, Lower limb, Time lag, Hospitalization, Costs, Mortality, Morbidity, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0067847

    Code Inist : 002B25F. Création : 199608.