Does a shortened clinical pathway reduce costs in patients undergoing elective herniorrhaphy and laparoscopic cholecystectomy?
A shortened clinical pathway with day of surgery admission and early discharge reduces hospital costs for elective surgeries.
A recent study at the Prince of Wales Hospital (PoW) compared health outcomes and user satisfaction for conventional clinical pathways with a shortened pathway incorporating day of surgery admission (DOSA), early discharge and post acute care domiciliary visits for two high volume, elective surgical procedures (herniorrhaphy and laparoscopic cholecystectomy). This paper quantifies cost differences between the control and intervention groups for nursing salaries and wages, other ward costs, pathology and imaging. The study verified and measured the lower resource use that accompanies a significant reduction in length of stay (LOS). Costs of pre- and post-operative domiciliary visits were calculated and offset against savings generated by the re-engineered clinical pathway. Average costs per separation were at least 239 (herniorrhaphy) and 265 (laparoscopic cholecystectomy) lower for those on the DOSA pathway with domiciliary post acute care.
Board et al. (Thu,) studied this question.