Radical prostatectomy: balancing cost and patient care.
We have prospectively evaluated the impact on patient morbidity of cost-efficiency measures in the perioperative management of patients undergoing radical prostatectomy. A collaborative care pathway was developed to standardize care and eliminate unnecessary testing or intervention. The financial impact of this program has been dramatic, with a decrease in hospital charges from over $14 000 before the study to around $7000. The target date for hospital discharge of the second or third postoperative day is met by over 95% of patients. The use of blood products (including autologous blood) has virtually been eliminated. There has been no identifiable adverse effect on patient comfort or outcome, and patient satisfaction with the program has been extremely high. With careful foresight and continuous review, pathways can be developed which enhance the overall quality of care while minimizing treatment expense.
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Joseph A.
JA
Smith
Michael O.
MO
Koch