The cost benefit of changing protocols in the management of intussusception.
BACKGROUND
At a time when pressure is being applied to healthcare systems to reduce costs and improve efficiency, both the medical and financial implications of changing practices need to be documented.


METHODS
A review was undertaken of 703 patients with intussusception, treated during a 10-year period from 1983.


RESULTS
This review showed that changes to the protocol for the management of intussusception have not only benefited the patient by reducing the morbidity and the operative rate, but also have led to a reduction in the length of hospital stay, providing significant cost savings to the health system. The reduction in the operative rate accounts for an estimated annual saving at the Royal Children's Hospital of $139,000.


CONCLUSIONS
Improvements in the management of intussusception have resulted in significant reductions in the costs of treatments. The recent diagnosis-related group casemix funding arrangements mean, however, that the Royal Children's Hospital benefits more financially from inappropriate operative management of intussusception, than from non-operative management. Funding arrangements should not discourage optimal treatment.
Stein
J E
JE
Department of General Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
Beasley
S W
SW
Phelan
E
E
D001466:Barium Sulfate / Q000191:economics / Q000627:therapeutic use*; D002985:Clinical Protocols; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003953:Diagnosis-Related Groups; D004733:Enema; D006302:Health Services Research; D017721:Hospital Costs; D006776:Hospitals, Pediatric; D006801:Humans; D007443:Intussusception / Q000191:economics* / Q000628:therapy*; D007902:Length of Stay / Q000191:economics; D012051:Reimbursement Mechanisms; D012189:Retrospective Studies
D001466:Barium Sulfate