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- W2895093587 abstract "We previously used clinical variables to classify patients according to their risk of post-operative pancreatic fistula (POPF) and then developed unique, risk-based post-pancreatectomy clinical pathways (PPCP). We sought to evaluate the effect of these pathways on costs of care. Next, patients were assigned to a low-risk pancreatoduodenectomy (PD) (green), high-risk PD (orange), or distal pancreatectomy (DP) (blue) pathway. Adverse events data (including length of stay, LOS) were collected during the index hospitalization and for 90-days postoperatively. Direct health care costs were computed for the index-hospitalization and the 90-day postoperative period. The patients managed on PPCP were compared to a historic control group of patients treated prior to the initiation of the pathways. A total of 60 patients have been managed on the PPCP. The median LOS for pathway patients was 6 days, compared to 10 days for historic patients. There was a marked reduction in median LOS for the green (6 vs. 10 day, p = .002) and blue (5 vs. 7 days, p = .009) pathway patients, while orange pathway LOS was not different from the historic patients (12 vs. 14 days). Overall, the decreased in LOS resulted in a 27% reduction in median cost of index hospitalization. The green pathway resulted in the greatest reduction in cost at 31% with the blue pathway contributing a 19% cost savings, while the costs associated with the orange pathways increased by 2%. Creation and utilization of risk-stratified PPCP resulted in a marked decrease in LOS and costs of index hospitalization for green and blue pathways." @default.
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- W2895093587 date "2018-09-01" @default.
- W2895093587 modified "2023-09-26" @default.
- W2895093587 title "Reducing cost of hospitalization with risk stratified post-pancreatectomy clinical pathways at a single high-volume institution" @default.
- W2895093587 doi "https://doi.org/10.1016/j.hpb.2018.06.2530" @default.
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