Impact of a clinical pathway for elective infrarenal aortic reconstructions. Discussion.
Annual Scientific Session of the Southern Surgical Association. Hot Springs, VA, USA, 1997/11/30.
Objective To determine the impact of a clinical pathway for elective infrarenal aortic reconstruction on outcome, resource utilization, and cost in a university medical center.
Background Data Clinical pathways have been reported to control costs, reduce resource utilization, and maintain or improve the quality of patient care, although their use during elective aortic reconstructions remains unresolved.
Methods A clinical pathway was developed for elective infrarenal aortic reconstructions by a multidisciplinary group comprised of representatives from each involved service.
The prepathway practice and costs were analyzed and an efficient, cost-effective practice with specific outcome measures was defined.
The impact of the pathway was determined by retrospective comparison of outcome, resource utilization, and cost (total and direct variable) between the pathway patients (PATH, n=45) and a prepathway control group (PRE, n=20).
Results There were no significant differences in the patient demographics, comorbid conditions, operative indications, or type of reconstruction between the groups.
There were no operative deaths and the overall complication rate (PRE, 35% vs.
PATH, 34%) was similar.
The pathway resulted in significant decreases in the total length of stay and preoperative length of stay and a trend toward a significant decrease (p=0.08) in the intensive care length of stay for the admission during which the operation was performed. (...)
Mots-clés Pascal : Revascularisation chirurgicale, Bifurcation aortique, Implémentation, Optimisation, Coordination, Soin, Ressource, Coût, Evaluation performance, Homme, Chirurgie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Artère pathologie, Aorte pathologie, Organisation santé, Economie santé
Mots-clés Pascal anglais : Surgical revascularization, Aortic bifurcation, Implementation, Optimization, Coordination, Care, Resource, Costs, Performance evaluation, Human, Surgery, Cardiovascular disease, Vascular disease, Arterial disease, Aortic disease, Public health organization, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0321572
Code Inist : 002B25F. Création : 27/11/1998.