Patent ductus arteriosus ligation: are we doing better?
Limitation on health care resource use is stimulating critical evaluation of previous preoperative standards. We retrospectively reviewed the clinical and hospital financial records of all children admitted for patent ductus arteriosus ligation from July 1984 to April 1994 for age, perioperative length of stay, readmissions for postoperative surgical problem, and hospital charges adjusted to 1994 dollars. Patients with an isolated patent ductus arteriosus, greater than 3 months of age, without preoperative or postoperative complications were included in this study and stratified into two groups based on date of operation. Group I had operation before January 1, 1991, and group II had operation on or after January 1, 1991. Comparison of these two groups revealed a significant difference in perioperative length of stay (group I, 3.9 +/- 1.2 days [mean +/- standard deviation]; group II, 2.7 +/- 0.9 days; p < 0.0001) and in hospital charges (group I, $8,700 +/- $2,100; group II, $6,600 +/- $1,000; p < 0.0001). These data support the premise that children older than 3 months undergoing elective ligation of a patent ductus arteriosus have been treated with improved efficiency and less charge without an increase in postdischarge morbidity. Health care policy decisions have forced us to evaluate the standards of perioperative care more critically.
Novick
W M
WM
Department of Pediatric Cardiology, LeBonheur Children's Medical Center, University of Tennessee, Memphis.
Watson
D C
DC
Alpert
B S
BS
Becker
J A
JA
DiSessa
T G
TG
Ring
J C
JC
Birnbaum
S E
SE
Chase
N A
NA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D004374:Ductus Arteriosus, Patent / Q000191:economics* / Q000601:surgery; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission; D012189:Retrospective Studies