title: Establishment of a clinical pathway as an effective tool to reduce hospitalization and charges after video-assisted thoracoscopic pulmonary resection.
abstract: OBJECTIVE
  The purpose of this study was to assess the effect of establishing a clinical pathway based on the length of hospitalization, hospital charges, and the outcome for video-assisted thoracoscopic pulmonary resection (VATPR).
  
  
  METHODS
  We retrospectively analyzed consecutive patients who were diagnosed as having primary lung cancer, metastatic lung cancer, or a nodule that was suspected to be malignant and thus was operated on using VATPR during the 1-year period before (n = 105) and after (n = 113) pathway implementation.
  
  
  RESULTS
  The mean economic cost and total hospital stay before and after pathway implementation were about dollars 14439 and dollars 13093 (US), and 29.4 and 18.6 days, respectively. These figures were significantly lower after pathway implementation than before establishment of the pathway.
  
  
  CONCLUSIONS
  A clinical pathway is thus considered useful for reducing the length of total hospital stay and the costs associated with VATPR while maintaining high-quality postoperative care.
authors.affiliation: Department of Thoracic Oncology, Kyushu Cancer Center, Fukuoka, Japan. rmaruyama@nk-cc.go.jp
authors.forename: Riichiroh
authors.initials: R
authors.lastname: Maruyama
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyake
authors.forename: Miyako
authors.initials: M
authors.lastname: Kojo
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Aoki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Suemitsu
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Okamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wataya
authors.forename: Yukito
authors.initials: Y
authors.lastname: Ichinose
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D019091:Critical Pathways; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000191:economics; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000191:economics*; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000191:economics*; D016896:Treatment Outcome