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  1. Maintaining quality of care and patient satisfaction with radical prostatectomy in the era of cost containment.

    Article - En anglais

    Objectives

    To determine the effect of shortened hospital stay after radical retropubic prostatectomy on costs, adverse surgical outcomes, and patient satisfaction.

    Methods

    The effect of changes in preoperative counseling, perioperative care, and analgesic management on hospital length of stay ; mean cost per case and cost per hospital day ; and 30-day complication, hospital readmission, and mortality rates were analyzed for a consecutive sample of 374 patients undergoing radical prostatectomy between July 1989 and November 1995.

    Satisfaction with length of stay, analgesic regimen, and surgical outcome was assessed in a random subset of 150 patients by anonymous questionnaire.

    Results

    Length of stay (LOS) was shortened from a median 7 to 2 nights after surgery during the study (P<0.0001), whereas the acute complication, 30-day readmission, and 30-day mortality rates remained constant.

    Reducing LOS resulted in a 43% decrease in mean cost per case while mean cost per day increased by 22% to 35%. Overall patient satisfaction was high, with 83.5% of patients rating LOS as « just right » and 89.2% reporting they were « satisfied » or « very satisfied » with their pain control after surgery.

    Conclusions

    Shortened LOS after radical retropubic prostatectomy can be accomplished safely and can meet with high levels of patient satisfaction while significantly reducing hospital-related costs. (...)

    Mots-clés Pascal : Prostatectomie, Total, Evolution, Durée maintien, Hospitalisation, Qualité service, Soin, Réduction, Coût, Evaluation, Questionnaire, Etude statistique, Homme, Chirurgie, Appareil urinaire pathologie, Appareil génital mâle pathologie, Prostate pathologie, Economie santé

    Mots-clés Pascal anglais : Prostatectomy, Total, Evolution, Holding time, Hospitalization, Service quality, Care, Reduction, Costs, Evaluation, Questionnaire, Statistical study, Human, Surgery, Urinary system disease, Male genital diseases, Prostate disease, Health economy

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

    Cote : 96-0418209

    Code Inist : 002B30A04B. Création : 10/04/1997.