Resource utilization and pathways

Meeting the challenge of cost containment

William H. Edwards, William H. Edwards, Raymond S. Martin, Joseph L. Mulherin, Debbie Bullock

    Research output: Contribution to journalArticle

    12 Citations (Scopus)

    Abstract

    The 1990s will bring sweeping changes with managed care and capitation. To address this cost/quality paradox, selective intensive care utilization is coupled with clinical pathways as an innovative change for all patients having cerebral revascularization (CVR) or femoral revascularization (FR). From January 1,1991 through June 30,1995, data were accumulated on 2023 procedures in 1524 patients. The study was based on 848 CVRs and 1175 FRs. Intensive care unit (ICU) observation was necessary in 73 patients (3.6%) for cardiac or hypertensive management. Twenty-six patients (1.2%) transported to a vascular surgical floor from the postanesthesia recovery room required return to an ICU for complications during hospitalization. There were nine strokes or transient ischémie attacks (0.4%) in the CVR group, four myocardial infarctions (0.2%), and five perioperative deaths (0.3%). In the FR group, there were 14 deaths (0.9%). Readmission during the perioperative period, 30 days, was necessary in 46 patients (3.1%). Financial cost analysis revealed the mean adjusted cost for CVR in 1990 adjusted to 1995 dollars was $7223. The institution of case management reduced this to $4490 (37.8 per cent reduction in total hospital costs). The cost for FR in 1990 dollars adjusted to 1995 was $14,332 reduced to $5541 (a 59 per cent reduction in total hospital costs). This study suggests the use of clinical pathways does not impair quality of care, leads to no higher morbidity or mortality, and can produce significant cost savings to a hospital.

    Original languageEnglish (US)
    Pages (from-to)830-834
    Number of pages5
    JournalAmerican Surgeon
    Volume62
    Issue number10
    StatePublished - Dec 1 1996

    Fingerprint

    Cost Control
    Thigh
    Costs and Cost Analysis
    Critical Pathways
    Hospital Costs
    Intensive Care Units
    Cerebral Revascularization
    Recovery Room
    Perioperative Period
    Cost Savings
    Quality of Health Care
    Case Management
    Managed Care Programs
    Critical Care
    Blood Vessels
    Hospitalization
    Stroke
    Myocardial Infarction
    Observation
    Morbidity

    All Science Journal Classification (ASJC) codes

    • Surgery

    Cite this

    Edwards, W. H., Edwards, W. H., Martin, R. S., Mulherin, J. L., & Bullock, D. (1996). Resource utilization and pathways: Meeting the challenge of cost containment. American Surgeon, 62(10), 830-834.

    Resource utilization and pathways : Meeting the challenge of cost containment. / Edwards, William H.; Edwards, William H.; Martin, Raymond S.; Mulherin, Joseph L.; Bullock, Debbie.

    In: American Surgeon, Vol. 62, No. 10, 01.12.1996, p. 830-834.

    Research output: Contribution to journalArticle

    Edwards, WH, Edwards, WH, Martin, RS, Mulherin, JL & Bullock, D 1996, 'Resource utilization and pathways: Meeting the challenge of cost containment', American Surgeon, vol. 62, no. 10, pp. 830-834.
    Edwards WH, Edwards WH, Martin RS, Mulherin JL, Bullock D. Resource utilization and pathways: Meeting the challenge of cost containment. American Surgeon. 1996 Dec 1;62(10):830-834.
    Edwards, William H. ; Edwards, William H. ; Martin, Raymond S. ; Mulherin, Joseph L. ; Bullock, Debbie. / Resource utilization and pathways : Meeting the challenge of cost containment. In: American Surgeon. 1996 ; Vol. 62, No. 10. pp. 830-834.
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