Cost containment is a reality in thoracic surgery.
Patient care pathways have proved effective in cardiac surgery to reduce length of stay and control costs.
A multidisciplinary team formulated a pulmonary lobectomy patient care pathway to standardize care, reduce length of stay and costs, and maintain quality.
Variance codes were developed to collect data prospectively on reasons for prolonged stay.
A patient satisfaction survey was instituted to learn patients'responses to their hospitalization.
One hundred forty-seven patients underwent lobectomy in 1995 before institution of the pathway with a mean length of stay of 10.6 days and a mean cost of $16,063.
The lobectomy pathway was instituted at the beginning of 1996.
One hundred thirty patients underwent lobectomy in 1996 with a mean length of stay of 7.5 days (p=0.03) and a mean cost of $14,792 (p=0.47).
Readmission and mortality rates were unchanged.
Eighty-eight of 130 patients (68%) were able to be discharged by the target length of stay of 7 days in 1996 as opposed to 76 of 147 patients (52%) in 1995.
The most common reason for delayed discharge was inadequate pain control.
The majority of patients felt prepared for discharge by the seventh postoperative day (70 of 96 patients, 73%). Conclusions.
The institution of a lobectomy patient care pathway appeared to reduce length of stay and costs. (...)
Mots-clés Pascal : Poumon pathologie, Lobectomie, Analyse avantage coût, Economie santé, Evaluation, Hospitalisation, Durée, Etats Unis, Amérique du Nord, Amérique, Traitement, Homme, Appareil respiratoire pathologie, Chirurgie
Mots-clés Pascal anglais : Lung disease, Lobectomy, Cost benefit analysis, Health economy, Evaluation, Hospitalization, Duration, United States, North America, America, Treatment, Human, Respiratory disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0460731
Code Inist : 002B25D. Création : 03/02/1998.