Clinical pathways are being introduced by hospitals to reduce costs and control unnecessary variation in care.
We studied 766 inpatients to measure the impact of a perioperative clinical pathway for patients undergoing knee replacement surgery on hospital costs.
One hundred twenty patients underwent knee replacement surgery before the development of a perioperative clinical pathway, and 63 patients underwent knee replacement surgery after pathway implementation.
As control groups, we contemporaneously studied 332 patients undergoing radical prostatectomy (no clinical pathway in place for these patients) and 251 patients undergoing hip replacement surgery without a clinical pathway (no clinical pathway and same surgeons as patients having knee replacement surgery).
Total hospitalization costs (not charges), excluding professional fees, were computed for all patients.
Mean (±SD) hospital costs for knee replacement surgery decreased from $21,709 ± $5985 to $17,618 ± $3152 after implementation of the clinical pathway.
The percent decrease in hospitalization costs was 1.56-fold greater (95% confidence interval 1.02-2.28) in the knee replacement patients than in the radical prostatectomy patients and 2.02-fold greater (95% confidence interval 1.13-5.22) than in the hip replacement patients.
If patient outcomes (e.g.
Mots-clés Pascal : Chirurgie orthopédique, Genou, Contrôle coût, Qualité, Soin intégré, Recommandation, Homme, Analyse coût, Economie santé, Hôpital, Etats Unis, Amérique du Nord, Amérique, Référence médicale
Mots-clés Pascal anglais : Orthopedic surgery, Knee, Cost control, Quality, Managed care, Recommendation, Human, Cost analysis, Health economy, Hospital, United States, North America, America
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0249152
Code Inist : 002B25I. Création : 11/09/1998.