Cost containment in cardiac surgery

results with a critical pathway for coronary bypass surgery at the New York hospital-Cornell Medical Center.

F. T. Velasco, W. Ko, T. Rosengart, N. Altorki, S. Lang, Jeffrey P Gold, K. H. Krieger, O. W. Isom

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

PURPOSE: A multidisciplinary project was undertaken at The New York Hospital-Cornell Medical Center to develop critical pathways for open-heart surgery to help reduce cost, shorten hospital length of stay (LOS), and streamline patient care. METHODS: A critical pathway for elective coronary artery bypass grafting instituted on March 1, 1995, was developed through a cooperative effort involving surgeons, anesthesiologists, nurses, social workers, physical therapists, nutritionists, and patient case managers. Prospective data collected on consecutive patients forming a critical pathway group (n = 114) over a 6-month period were compared with retrospective data on consecutive patients forming a cohort group (n = 382) who underwent elective coronary artery bypass grafting in 1994. RESULTS: The critical pathway group of patients experienced a significantly shorter total hospital LOS (7.7 +/- 2.3 days vs 11.1 +/- 6 days, p < 0.0001) and shorter intensive care unit LOS (1.5 +/- 0.9 days vs 2.0 +/- 2.8 days, p < 0.0001). Direct costs were computed by use of hospital charges multiplied by the Medicare cost-to-charge ratio. Mean hospital direct cost (ancillary resources) was $1181 lower in the critical pathway group when compared with the control group (p < 0.0001). The postoperative mortality and readmission rates were similar for the two groups of patients. CONCLUSIONS: The ongoing analysis of cost, LOSs, and outcomes has made possible a process of continuous quality improvement on the cardiothoracic service in which further areas for improvement are identified and studied. The use of a critical pathway for elective coronary artery bypass grafting at our institution significantly reduced hospital LOS and direct costs while maintaining the overall quality of patient care.

Original languageEnglish (US)
Pages (from-to)21-28
Number of pages8
JournalBest practices and benchmarking in healthcare : a practical journal for clinical and management application
Volume1
Issue number1
StatePublished - Jan 1 1996

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Critical Pathways
Cost Control
Thoracic Surgery
Length of Stay
Costs and Cost Analysis
Coronary Artery Bypass
Patient Care
Hospital Charges
Nutritionists
Hospital Costs
Quality of Health Care
Physical Therapists
Medicare
Quality Improvement
Intensive Care Units
Nurses
Control Groups
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Cost containment in cardiac surgery : results with a critical pathway for coronary bypass surgery at the New York hospital-Cornell Medical Center. / Velasco, F. T.; Ko, W.; Rosengart, T.; Altorki, N.; Lang, S.; Gold, Jeffrey P; Krieger, K. H.; Isom, O. W.

In: Best practices and benchmarking in healthcare : a practical journal for clinical and management application, Vol. 1, No. 1, 01.01.1996, p. 21-28.

Research output: Contribution to journalArticle

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