Estimated costs before, during and after the introduction of the emergency laparotomy pathway quality improvement care (ELPQuIC) bundle.
Implementation of a quality improvement bundle for peri-operative management of emergency laparotomy (ELPQuIC) improved mortality in a previous study. We used data from one site that participated in that study to examine whether it was associated with the cost of care. We collected data from 396 patients: 144 before, 144 during and 108 after implementation of the bundle. We estimated costs incurred using previously published methodology based on the time the patient spent in hospital, in the operating theatre and in critical care. Duration of stay in hospital and critical care did not differ between time periods, p = 0.14 and p = 0.28, respectively. The costs per patient and per survivor did not differ between the time periods, p = 0.87 and p = 0.17, respectively. Costs were similar for patients aged < 80 years vs. ≥ 80 years. Implementation of a quality improvement bundle for emergency laparotomy has the capacity to save lives without increasing hospital costs.
Department of Anaesthesia, Royal United Hospital NHS Foundation Trust, Bath, UK. moeveleigh@gmail.com.
M O
MO
Eveleigh
Department of Anaesthesia, Royal United Hospital NHS Foundation Trust, Bath, UK.
T E
TE
Howes
Department of Anaesthesia, Royal United Hospital NHS Foundation Trust, Bath, UK.
C J
CJ
Peden
Department of Anaesthesia, Royal United Hospital NHS Foundation Trust, Bath, UK.
T M
TM
Cook
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000191:economics; D019091:Critical Pathways / Q000191:economics* / Q000592:standards; D004630:Emergencies; D004739:England; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D007813:Laparotomy / Q000191:economics* / Q000592:standards*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D019990:Perioperative Care / Q000191:economics / Q000592:standards; D058996:Quality Improvement; D055815:Young Adult
economics; emergency laparotomy; patient care quality measures