Litwin M S, Smith R B, Thind A, Reccius N, Blanco-Yarosh M, deKernion J B
Department of Surgery/Urology (School of Medicine), University of California, Los Angeles, USA.
J Urol. 1996 Mar;155(3):989-93.
We assessed changes in hospital costs and resource use among patients undergoing radical prostatectomy following implementation of a clinical care path.
A standardized clinical care path for patient management before and after radical prostatectomy was developed and implemented at a large academic medical center in California. All 577 consecutive patients undergoing radical prostatectomy during the 3 years before and 1 year after implementation of the care path were included in the study. Each patient was entered prospectively into a hospital-wide financial data base, which served as the source for observations on hospital costs, hospital charges and length of stay.
After implementation of the radical prostatectomy care path hospital costs decreased by 12% ($7,916 versus $6,934, p < 0.001), hospital charges decreased by 20% ($17,005 versus $13,524, p < 0.0001) and length of stay decreased by 28% (5 versus 3.6 days, p < 0.0001). Decreases were noted in all categories of the hospital patient financial profile, except operating room charges.
By standardizing preoperative and postoperative management for patients undergoing radical prostatectomy, significant savings can be achieved over and above existing trends toward shorter hospital stays and lower hospital costs.
我们评估了实施临床护理路径后接受根治性前列腺切除术患者的医院成本和资源使用变化。
在加利福尼亚州的一家大型学术医疗中心制定并实施了根治性前列腺切除术前后患者管理的标准化临床护理路径。纳入了护理路径实施前3年和实施后1年期间连续接受根治性前列腺切除术的所有577例患者。每位患者前瞻性地录入医院范围的财务数据库，该数据库作为观察医院成本、医院收费和住院时间的来源。
实施根治性前列腺切除术护理路径后，医院成本降低了12%（从7916美元降至6934美元，p<0.001），医院收费降低了20%（从17005美元降至13524美元，p<0.0001），住院时间缩短了28%（从5天降至3.6天，p<0.0001）。除手术室收费外，医院患者财务概况的所有类别均出现下降。
通过对接受根治性前列腺切除术患者的术前和术后管理进行标准化，除了现有住院时间缩短和医院成本降低的趋势外，还可实现显著的节约。
