Clinical information system that enhances the use of resources in endoscopic prostatic procedures.
In this study we evaluated, by means of an automated management system, the identification of subgroups of patients within certain operative categories whose predictable length of stay was compatible with treatment on a 5-day ward. This was achieved by using a computer directed analysis of urological workload on prospectively collected clinical data. Graphical presentation of the results was achieved by a technique known as the patient-bed dissociation curve. Patients with bladder outflow obstruction treated by transurethral prostatic resection (701) and bladder neck incision (113) were selected from a total of 7,162 hospital admissions. The main outcome measures were length of stay and complication rates for the 2 procedures. The results demonstrated that a group of patients about to undergo transurethral resection could be selected by age and source which would indicate an 18% greater probability of discharge within 5 days. These patients were easily identifiable in advance and would be suitable for treatment on a 5-day ward. It was concluded that computer-held clinical data were easily accessible to the surgeon. The process of detailed analysis need not take time. With properly directed studies the information retrieved could be used to effect change. The patient-bed dissociation curve may prove a valuable tool in examining and comparing discharge patterns in any groups of patients.
Emberton
M
M
Department of Surgery, Hammersmith Hospital, London.
Ellis
B W
BW
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D004724:Endoscopy / Q000191:economics / Q000706:statistics & numerical data; D004739:England; D006751:Hospital Information Systems; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000191:economics / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery; D014573:Urology Department, Hospital / Q000706:statistics & numerical data*; D016526:Workload