Influence of patient age and co-morbidity on outcome of a collaborative care pathway after radical prostatectomy and cystoprostatectomy.
OBJECTIVE
We determined whether standardized care patterns developed with a collaborative care methodology can be applied successfully across all patient groups with favorable effects on cost and quality.


METHODS
We retrospectively analyzed financial and clinical outcomes in 109 radical retropubic prostatectomy and 47 radical cystectomy cases. Patients older than 70 years and/or with an American Society of Anethesiology status of 3 or greater were compared to younger, healthier patients undergoing these procedures.


RESULTS
Standardized care patterns resulted in favorable financial and clinical outcomes in high and low risk patient groups. The only apparent difference was an increased need for rehospitalization after discharge for patients undergoing radical prostatectomy with a high American Society of Anesthesiology status.


CONCLUSIONS
Standardized care patterns developed with a collaborative care methodology provide a high quality, cost-efficient approach to medical care. This methodology is applicable to all patient groups and is highly compatible with current medical practice.
Koch
M O
MO
Department of Urology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Smith
J A
JA
D000367:Age Factors; D000368:Aged; D001483:Base Sequence; D015897:Comorbidity; D019091:Critical Pathways; D015653:Cystectomy / Q000009:adverse effects / Q000191:economics / Q000592:standards*; D005069:Evaluation Studies as Topic; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000009:adverse effects / Q000191:economics / Q000592:standards*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D013714:Tennessee / Q000453:epidemiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery*; D014547:Urinary Diversion