Process improvements reduce utilization of resources for aortic aneurysm repair

The Journal of Surgical Research
T H SchwarczG L Hyde

Abstract

In conjunction with the VA reorganization to promote greater efficiency of health care provision, ambulatory surgery (AS) programs have been created. These programs institute outpatient preoperative assessment and operative management. This study examines the impact of these process changes on resources utilized by patients requiring repair of abdominal aortic aneurysms (AAAs). The medical records of 15 consecutively treated patients undergoing elective, infrarenal AAA repair before (1992-1993) and after (1995-1996) AS implementation were reviewed. Resource utilization was assessed by evaluating preoperative tests performed (inpatient or outpatient), ICU days, and inpatient length of stay (LOS). Postoperative morbidity and mortality were noted. Patient age, AAA size, and prevalence of diabetes mellitus, hypertension, cardiac disease, COPD, and tobacco use were similar between the two groups. Abdominal ultrasound, CT scanning, and angiography were significantly more frequently performed on an outpatient basis after implementation of the AS program. The median preoperative LOS was reduced in the AS group (1 vs 6 days, P = 0.001, Student t test), resulting in a lower inpatient LOS (11 vs 16, P < 0.01, Student t test). All patients...Continue Reading

References

Feb 1, 1996·Journal of Vascular Surgery·A KazmersE Bates
May 1, 1996·Journal of Vascular Surgery·B L Gewertz
Oct 31, 1996·The New England Journal of Medicine·J K Iglehart
Dec 1, 1996·Journal of the American College of Cardiology·A N DeMariaD P Bodycombe

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Citations

Nov 15, 2006·International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services·S G ElkhuizenN S Klazinga
Dec 20, 2000·The Journal of Surgical Research·F N LittooyC Chmura

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