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  1. Pulmonary lobectomy patient care pathway : A model to control cost and maintain quality.

    Article - En anglais


    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

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

    Cote : 97-0460731

    Code Inist : 002B25D. Création : 03/02/1998.