Impact of a clinical pathway for radical retropubic prostatectomy.
Cost containment has become an important issue in medical practice.
With the implementation of collaborative care programs and critical pathways, substantial reduction in overall costs can be achieved while maintaining the quality of care and patient satisfaction.
Our series consists of 856 consecutive patients treated with radical retropubic prostatectomy by 24 surgeons in a single hospital between January 1,1994, and January 31,1997.
A clinical pathway for radical retropubic prostatectomy was implemented July 1,1994.
The patients were subdivided into three groups :
(1) baseline : patients who underwent surgery in the 6 months immediately before the pathway onset (n=113) ;
(2) nonpathway : 75 patients treated off the clinical pathway ;
and (3) pathway : 668 men placed on the clinical pathway.
We compare average length of stay and average hospital charges among the three groups.
We also compare average length of stay among physician volume groups : high volume physicians performed at least 12 operations per year ; low volume physicians performed less than 12 operations per year.
Charges were further broken down by department.
Patient satisfaction was recorded by an outside source after discharge.
Postoperative complications were assessed in the clinical pathway and nonpathway groups.
Average hospital charges and average length of stay were $12,926 and 5.8 days for baseline patients (...)
Mots-clés Pascal : Prostatectomie, Voie abord, Laparotomie, Implémentation, Plan traitement, Evaluation, Coût, Hospitalisation, Evaluation performance, Homme, Chirurgie, Appareil urinaire pathologie, Prostate pathologie, Appareil génital mâle pathologie, Economie santé
Mots-clés Pascal anglais : Prostatectomy, Surgical approach, Laparotomy, Implementation, Treatment planning, Evaluation, Costs, Hospitalization, Performance evaluation, Human, Surgery, Urinary system disease, Prostate disease, Male genital diseases, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0362842
Code Inist : 002B25H. Création : 25/01/1999.