Kostenanalyse des Fast-Track-Konzeptes bei elektiver Kolonchirurgie
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Kostenanalyse des Fast-Track-Konzeptes bei elektiver Kolonchirurgie. / Jurowich, C F; Reibetanz, J; Krajinovic, K; Larena-Avellaneda, A; Isbert, C; Oberender, P; Germer, C T; von Rahden, B H A.
in: ZBL CHIR, Jahrgang 136, Nr. 3, 06.2011, S. 256-63.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Kostenanalyse des Fast-Track-Konzeptes bei elektiver Kolonchirurgie
AU - Jurowich, C F
AU - Reibetanz, J
AU - Krajinovic, K
AU - Larena-Avellaneda, A
AU - Isbert, C
AU - Oberender, P
AU - Germer, C T
AU - von Rahden, B H A
N1 - © Georg Thieme Verlag Stuttgart ˙ New York.
PY - 2011/6
Y1 - 2011/6
N2 - INTRODUCTION: Fast track (FT) is a modern concept to enhance postoperative recovery after elective surgery. It has been approved during the last years. Beside its medical benefits, fast-track (FT) concepts may provide an economic incentive, although a cost-benefit analysis in the daily clinical routine has not yet been realised. In addition to this an elevated consumption of resources is postulated.PATIENTS AND METHODS: In 2007 we prospectively studied the implementation of the FT concept for elective colonic surgery in the daily clinical routine at the Department of General Surgery of Nuremberg Hospital. In a representative subgroup of patients studied, we performed a cost-cost analysis by comparing these patients to a retrospectively analysed group that had been treated in a conventional traditional manner in 2002.RESULTS: 369 patients were included and treated according to the FT concept. Discharge criteria were met at the 4(th) postoperative day in median (SD 3.9 days, minimum 1, maxiumum 29 days). The rate of general postoperative complications was 24.4 % (16 % minor complications) for all patients and 6.6 % in the group of patients who were discharged within 9 postoperative days or less (n=182). With respect to the main FT items, implementation of the FT concept was considered as effective. Cost-cost analyses showed a cost reduction of 32 % in favour of patients treated with the FT concept.CONCLUSION: This study clearly shows the clinical and economic benefits of the FT concept considering health services research. Therefore further clinical implementation of the FT concept seems beneficial, not only in the view of medical aspects, but also for economic reasons.
AB - INTRODUCTION: Fast track (FT) is a modern concept to enhance postoperative recovery after elective surgery. It has been approved during the last years. Beside its medical benefits, fast-track (FT) concepts may provide an economic incentive, although a cost-benefit analysis in the daily clinical routine has not yet been realised. In addition to this an elevated consumption of resources is postulated.PATIENTS AND METHODS: In 2007 we prospectively studied the implementation of the FT concept for elective colonic surgery in the daily clinical routine at the Department of General Surgery of Nuremberg Hospital. In a representative subgroup of patients studied, we performed a cost-cost analysis by comparing these patients to a retrospectively analysed group that had been treated in a conventional traditional manner in 2002.RESULTS: 369 patients were included and treated according to the FT concept. Discharge criteria were met at the 4(th) postoperative day in median (SD 3.9 days, minimum 1, maxiumum 29 days). The rate of general postoperative complications was 24.4 % (16 % minor complications) for all patients and 6.6 % in the group of patients who were discharged within 9 postoperative days or less (n=182). With respect to the main FT items, implementation of the FT concept was considered as effective. Cost-cost analyses showed a cost reduction of 32 % in favour of patients treated with the FT concept.CONCLUSION: This study clearly shows the clinical and economic benefits of the FT concept considering health services research. Therefore further clinical implementation of the FT concept seems beneficial, not only in the view of medical aspects, but also for economic reasons.
KW - Aged
KW - Colectomy/economics
KW - Colonic Diseases/economics
KW - Colorectal Neoplasms/economics
KW - Cost Savings/economics
KW - Cost-Benefit Analysis/economics
KW - Female
KW - Germany
KW - Humans
KW - Intensive Care Units/economics
KW - Length of Stay/economics
KW - Male
KW - Middle Aged
KW - National Health Programs/economics
KW - Outcome and Process Assessment, Health Care
KW - Postoperative Complications/economics
KW - Prospective Studies
KW - Rectal Diseases/economics
KW - Rectum/surgery
U2 - 10.1055/s-0029-1224745
DO - 10.1055/s-0029-1224745
M3 - SCORING: Zeitschriftenaufsatz
C2 - 20607651
VL - 136
SP - 256
EP - 263
JO - ZBL CHIR
JF - ZBL CHIR
SN - 0044-409X
IS - 3
ER -