Annual Symposium of the Association of Veterans Administration Surgeons. Louisville, KY, USA, 1997/05/05.
In conjunction with the VA reorganization to promote greater efficiency of health care provision, ambulatory surgery (AS) programs have been created.
These programs institute outpatient preoperative assessment and operative management.
This study examines the impact of these process changes on resources utilized by patients requiring repair of abdominal aortic aneurysms (AAAs).
The medical records of 15 consecutively treated patients undergoing elective, infrarenal AAA repair before (1992-1993) and after (1995-1996) AS implementation were reviewed.
Resource utilization was assessed by evaluating preoperative tests performed (inpatient or outpatient), ICU days, and inpatient length of stay (LOS).
Postoperative morbidity and mortality were noted.
Patient age, AAA size, and prevalence of diabetes mellitus, hypertension, cardiac disease, COPD, and tobacco use were similar between the two groups.
Abdominal ultrasound, CT scanning, and angiography were significantly more frequently performed on an outpatient basis after implementation of the AS program.
The median preoperative LOS was reduced in the AS group (1 vs 6 days, P=0.001, Student t test), resulting in a lower inpatient LOS (11 vs 16, P<0.01, Student t test).
All patients survived and the incidence of complications was similar between the groups.
Hospital resource utilization was significantly decreased, largely by shifting preoperative assessment to the outpatient setting. (...)
Mots-clés Pascal : Anévrysme, Aorte, Evaluation, Gestion ressources, Amélioration procédé, Postopératoire, Réparation, Homme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Aorte pathologie, Artère pathologie, Economie santé, Chirurgie
Mots-clés Pascal anglais : Aneurysm, Aorta, Evaluation, Resource management, Process improvement, Postoperative, Repair, Human, Cardiovascular disease, Vascular disease, Aortic disease, Arterial disease, Health economy, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0267961
Code Inist : 002B25F. Création : 11/09/1998.