Improving cost efficiency on a vascular surgery service.
BACKGROUND
A vascular task force (VTF) consisting of two vascular surgeons and other key personnel was established to reduce costs and improve efficiency in the management of patients on a vascular surgery service.


METHODS
The VTF met monthly beginning in 1994 to study and implement changes in the management of patients with (1) abdominal vascular, (2), carotid endarterectomy (3) distal bypass, and (4) other vascular procedures, including amputations. Length of stay, and fixed and variable costs were assessed for change over time using Pearson correlation coefficients.


RESULTS
Improvements in efficiency (length of stay) and decreases in costs (fixed and variable costs) from fiscal year 1993 to fiscal year 1996 were significant for the total group of vascular patients (P </=0.001), with some intergroup differences. The major improvements were in the abdominal vascular and carotid endarterectomy groups, where length of stay and fixed and variable costs were reduced significantly (P </=0.01). Management of distal bypass and other vascular surgery patients showed less striking improvement.


CONCLUSIONS
Vascular surgeons in collaboration with other dedicated personnel involved in the care of vascular patients can improve efficiency and reduce costs. Advances were greatest in patients who required operations for carotid and abdominal vascular disorders and least for patients who required distal bypasses and other vascular procedures.
Skillman
J J
JJ
Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
Paras
C
C
Rosen
M
M
Davis
R B
RB
Kim
D
D
Kent
K C
KC
D000005:Abdomen / Q000601:surgery; D000368:Aged; D000671:Amputation, Surgical / Q000191:economics; D003363:Cost Control; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D016894:Endarterectomy, Carotid / Q000191:economics; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008505:Medical Staff, Hospital / Q000191:economics / Q000458:organization & administration; D011150:Popliteal Artery / Q000601:surgery; D013503:Surgery Department, Hospital / Q000191:economics* / Q000458:organization & administration; D016909:Tibial Arteries / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000145:classification / Q000191:economics* / Q000458:organization & administration; D000078329:Workforce