Accelerated surgical stay programs. A mechanism to reduce health care costs.
OBJECTIVE
To increase cost-efficiency while maintaining the standard of medical care, an accelerated surgical stay program for patients having breast surgery was instituted.


BACKGROUND
In the past 20 years, annual health care costs have soared and now comprise 12.2% of the United States gross national product. The annual inflation rate of almost 11% has prompted third-party payers to scrutinize hospital costs as hospitals now consume 38% of health care costs.


METHODS
A multidisciplinary task force was formed to analyze and reduce lengths of stay for breast surgeries and to standardize clinical protocols to address ensuing issues.


RESULTS
After 1 year, this prospective study found a 39% decrease in average length of stay and a 22% increase in patient volume. This was also accompanied by a low incidence of surgical complications. Through information obtained from 373 consecutive patients through telephone surveys and questionnaires, the Center for Cost-Effective Care reported high patient acceptance and satisfaction.


CONCLUSIONS
As a management strategy, accelerated surgical stay programs increase operating efficiency and reduce medical care costs without compromising quality of patient care. Success of this program was attributed to support from senior management, expansion of available educational resources for patients, and to a carefully planned transition from the program's developmental to its operational phase.
Pedersen
S H
SH
Center for Cost-Effective Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Douville
L M
LM
Eberlein
T J
TJ
D001943:Breast Neoplasms / Q000191:economics / Q000601:surgery*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011787:Quality of Health Care; D016896:Treatment Outcome; D014481:United States