Clinical Pathways for Acute Appendicitis: Approach for DRG.
- Author:
Dae Kun YOON
1
;
Dong Gue SHIN
;
Do Seong KWON
;
Bok Hee CHOI
;
Youn Hee LEE
;
Young Woo KIM
;
Jae Moon BAE
;
Ho Seong HAN
;
Kim Ja CHOI
;
Ok Young KIM
Author Information
1. Department of Surgery, Ewha Womans University College of Medicine.
- Publication Type:Original Article
- Keywords:
Clinical pathways;
Appendicitis;
Cost
- MeSH:
Appendicitis*;
Chronic Disease;
Critical Pathways*;
Delivery of Health Care;
Diagnosis;
Diagnosis-Related Groups*;
Hospital Costs;
Hospitalization;
Humans;
Patient Care;
Patient Care Team;
Patient Satisfaction;
Prospective Studies
- From:Journal of the Korean Surgical Society
2000;58(1):115-120
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The current health care system demands provision of quality patient care in a cost-effective manner. A clinical path defines an optimal sequencing and timing of intervention by a health care team. This path facilitates the streamlining of this process. Implementation of clinical paths may decrease hospital cost without increasing complications in acute appendicitis patients. METHODS: A prospective evaluation of a clinical pathway for acute appendicitis (during March 1999) was conducted and the results were compared with those for control patients (during Feb 1999). Pregnant patients or patients with chronic disease were excluded. The patients with acute appendicitis were classified into three groups: A-type for acute focal and suppurative appendicitis, B-type for gangrenous appendicitis, and C-type for perforative appendicitis. RESULTS: The data for 40 patients with a clinical pathway were compared to those for 30 control patients. The mean age was 25.3 11.7 years in the pathway group versus 39.3 15.8 years in the control group. The mean hospital duration were 4.5 days for the pathway with A-type appendicitis versus 5 days for the control patients (p<0.05) and the mean hospital cost was 85.73% of that for the control group (p<0.05). In B- and C-type, the hospital duration and the cost were not different. The satisfaction rates were increased in all the types of pathway patients. The complication rates for in all the pathways were no different from those for the control patients. CONCLUSION: The clinical pathway with A-type appendicitis decreased the duration of hospitalization and the cost without adversely affecting the diagnosis or the therapy. The clinical paths were useful as means to minimize cost while increasing patient satisfaction.
