Do clinical pathways for major vascular surgery improve outcomes and reduce cost ?
Annual Symposium on Vascular Surgery of the Society for Clinical Vascular Surgery. Naples (USA), 1997/03/12.
This study was performed to determine whether the implementation of clinical pathways for patients who undergo major vascular procedures in a community hospital would shorten the length of stay and reduce charges when compared with Medicare standards.
Length of stay, hospital costs, and morbidity, mortality, and readmission rates for the four most common vascular diagnosis-related group (DRG) categories at our institution were compared with Medicare standards.
The four categories were DRG 005 (extracranial vascular procedures), DRG 110 (aortic and renal procedures), DRG 478 (leg bypass with comorbidity), and DRG 479 (leg bypass without comorbidity).
Between May 1,1994, and June 30,1996,112 patients underwent carotid endarterectomy, 42 patients underwent aortic or renal procedures, and 130 patients underwent lower extremity bypass procedures (68% with comorbidity).
Only Medicare patients were included because exact cost/reimbursement data were available.
No admissions were excluded.
The average length of stay was 1.2 days for DRG 005,6.9 days for DRG 110, and 3.2 and 2.1 days for DRGs 478 and 479, respectively.
The average cost savings when compared with the Medicare reimbursement was $4338 for DRG 005, $7161 for DRG 110, $4108 for DRG 478, and $2313 for DRG 479.
Readmission was necessary for 9% of peripheral bypass patients. (...)
Mots-clés Pascal : Chirurgie, Appareil circulatoire, Qualité, Soin, Durée, Hospitalisation, Coût, Amélioration, Homme
Mots-clés Pascal anglais : Surgery, Circulatory system, Quality, Care, Duration, Hospitalization, Costs, Improvement, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0448487
Code Inist : 002B25F. Création : 03/02/1998.