[Impact of a clinical pathway in cases of transurethral resection of the prostate].
OBJECTIVE
Because of recent increases in health care costs, cost containment has become a important issue in medical practice. We evaluated the effect on cost and clinical outcome with the implementation of clinical care pathway for transurethral resection of the prostate (TURP) patients.


METHODS
Our series consists of 69 consecutive patients treated with TURP between June 1, 1999 and March 31, 2000. The patients were divided into two groups at random. Thirty-two patients were treated on the clinical pathway (pathway group) and 37 patients were not placed on the clinical pathway program (non-pathway group). Total hospital charges, average length of stay and clinical outcomes were compared in two groups.


RESULTS
The average of total hospital charges (insurance points) and average length of stay were 48,424.2 point, and 12.7 days for the pathway group, and 55.365.5 point, and 14.7 days for non-pathway group respectively. Postoperative complications and rehospitalization did not differ between two groups.


CONCLUSIONS
With the implementation of the clinical care pathway, average hospital charges and length of stay were reduced. The clinical pathway program is considered to be a good tool for health care cost management. This methodology can be applied to all patients. However, when we make the clinical pathway program, we take into account the individuality of each patients.
Aizawa
Taku
T
Department of Urology, Tokyo Medical University Hospital.
Kin
Taisei
T
Kitsukawa
Shin-ichi
S
Mamiya
Yoshimi
Y
Akiyama
Akihito
A
Ohno
Yoshio
Y
Okubo
Yuhei
Y
Miki
Makoto
M
Tachibana
Masaaki
M
D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000706:statistics & numerical data; D017722:Hospital Charges; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000191:economics / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000191:economics*