title: Understanding the impact of a clinical care pathway for major head and neck cancer resection on postdischarge healthcare utilization.
abstract: The purposes of this study were to explore the association of a postoperative clinical care pathway for patients undergoing major head and neck surgery with microvascular reconstruction on postdischarge health care utilization and cost and to compares a nonpathway group (n = 60) to a prospective, pathway-managed group (n = 54). Our primary purpose was to understand whether pathway-managed patients used postdischarge health care resources differently than patients managed without a care pathway.
  
  
  
  Health care utilization data (counts and costs) were collected for the 3 months after discharge. Differences in utilization were compared using Poisson regression. The null hypothesis was that there were no differences in utilization between the pathway and nonpathway groups.
  
  
  
  Pathway patients had fewer postdischarge encounters in 2 of 4 sectors. Readmission costs were significantly less in the pathway group only.
  
  
  
  A postoperative inpatient clinical care pathway in patients with head and neck cancer is associated with decreased health care utilization and inpatient costs in the 3 months after discharge. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1216-E1220, 2016.
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jonathan F
authors.identifier: 0000-0002-5989-2002
authors.initials: JF
authors.lastname: Dautremont
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Lucas R
authors.initials: LR
authors.lastname: Rudmik
authors.affiliation: Ohlson Research Initiative, Southern Alberta Cancer Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Nakoneshny
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Ohlson Research Initiative, Southern Alberta Cancer Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shamir P
authors.initials: SP
authors.lastname: Chandarana
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Ohlson Research Initiative, Southern Alberta Cancer Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: T Wayne
authors.initials: TW
authors.lastname: Matthews
authors.affiliation: Section of Plastic Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Christiaan
authors.initials: C
authors.lastname: Schrag
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Fick
authors.affiliation: Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Ohlson Research Initiative, Southern Alberta Cancer Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.|Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Dort
mesh_terms: D019091:Critical Pathways; D003627:Data Interpretation, Statistical; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011182:Postoperative Care / Q000592:standards*; D011446:Prospective Studies
keywords: care pathways; head and neck surgery; health care utilization; health economics; microvascular reconstruction