Koch M O, Smith J A
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Br J Urol. 1995 Jul;76(1):28-33. doi: 10.1111/j.1464-410x.1995.tb07827.x.
To develop and analyse a cost-containment programme for radical retropubic prostatectomy.
An in-depth analysis of the hospital charges associated with radical retropubic prostatectomy was conducted and a standard programme developed to control patient costs using a collaborative pathway method. The development of this programme and the outcomes of the first 50 patients who underwent radical retropubic prostatectomy while on the collaborative care pathway system are summarized.
The programme reduced both overall hospital charges per patient and the duration of hospital stay by 44%. In addition, there was a significant reduction in the duration of surgery, intra-operative blood loss and the need for transfusion. Implementation of this programme had no apparent adverse effects on the rates of major or minor complications or hospital readmissions, and was accepted well by the patients.
The collaborative care pathway developed for radical prostatectomy provides a system to deliver high quality, cost-efficient care in an environment which is highly acceptable to patients and which allows continued refinements in the care delivered.
制定并分析耻骨后根治性前列腺切除术的成本控制方案。
对耻骨后根治性前列腺切除术相关的医院收费进行深入分析,并采用协作路径法制定一个控制患者成本的标准方案。总结该方案的制定情况以及在协作护理路径系统下接受耻骨后根治性前列腺切除术的前50例患者的结果。
该方案使每位患者的总体医院收费和住院时间均减少了44%。此外,手术时间、术中失血量和输血需求也显著减少。实施该方案对主要或轻微并发症发生率或再次入院率没有明显不良影响,且患者接受度良好。
为根治性前列腺切除术制定的协作护理路径提供了一个系统,能在患者高度接受的环境中提供高质量、具有成本效益的护理,并允许对所提供的护理不断进行优化。