Although practice guidelines about appropriate lengths of stay have been widely promulgated, their effects on patient outcomes are not clear.
Our objective was to study the effects of length of stay practice guidelines on patient outcomes.
We performed a prospective, nonrandomized, interventional trial in six geographically distributed hospitals, among consecutively hospitalized « low-risk » patients with total hip replacement, hip fracture, or knee replacement.
Case managers provided physicians with patient risk information based on guideline recommendations.
We measured length of stay, compliance with recommended guideline length of stay, health status, hospital readmission rates, return to emergency department, return to work and recreation, and patient satisfaction.
A total of 560 patients were included in the study.
For patients with knee replacement, there was a statistically significant increase in practice guideline compliance (27% baseline versus 53% intervention, P<0.0001) and reduction in length of stay (5.2 days versus 4.6 days, P<0.001) when compared with the baseline period.
For hip replacement patients, there similarly was an increase in practice guideline compliance (66% baseline versus 82% intervention, P=0.01) and reduction in length of stay (5.1 days versus 4.8 days, P=0.03). (...)
Mots-clés Pascal : Hospitalisation, Etude multicentrique, Facteur sécurité, Temps séjour, Guide pratique, Chirurgie, Analyse coût efficacité, Homme, Organisation santé, Economie santé
Mots-clés Pascal anglais : Hospitalization, Multicenter study, Safety factor, Residence time, Handbook, Surgery, Cost efficiency analysis, Human, Public health organization, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0381662
Code Inist : 002B30A01C. Création : 25/01/1999.