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Titolo:
Impact of a pediatric asthma clinical pathway on hospital cost and length of stay
Autore:
Wazeka, A; Valacer, DJ; Cooper, M; Caplan, DW; DiMaio, M;
Indirizzi:
Cornell Univ, Presbyterian Hosp, Dept Pediat, New York, NY 10021 USA Cornell Univ New York NY USA 10021 p, Dept Pediat, New York, NY 10021 USA Cornell Univ, Joan & Sanford Weill Med Coll, New York, NY 10021 USA Cornell Univ New York NY USA 10021 Weill Med Coll, New York, NY 10021 USA Cornell Univ, Presbyterian Hosp, Off Clin Practice Evaluat, New York, NY USA Cornell Univ New York NY USA Off Clin Practice Evaluat, New York, NY USA
Titolo Testata:
PEDIATRIC PULMONOLOGY
fascicolo: 3, volume: 32, anno: 2001,
pagine: 211 - 216
SICI:
8755-6863(200109)32:3<211:IOAPAC>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEBULIZED IPRATROPIUM; CHILDREN; MANAGEMENT;
Keywords:
pediatric asthma; clinical pathway; asthma; outcome assessment; healthcare; children; hospital costs; economics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Wazeka, A Cornell Univ, Presbyterian Hosp, Dept Pediat, 525 E 68th St,RoomJ-114, New York, NY 10021 USA Cornell Univ 525 E 68th St,Room J-114 New York NY USA 10021 USA
Citazione:
A. Wazeka et al., "Impact of a pediatric asthma clinical pathway on hospital cost and length of stay", PEDIAT PULM, 32(3), 2001, pp. 211-216

Abstract

This study sought to determine if a clinical pathway developed and executed by specialists in pediatric asthma would reduce hospital costs and lengthof stay (LOS). The study design was a retrospective, nonrandomized, controlled trial. Subjects were children aged 2-18 years (N = 1,004) with a history of recurrent wheezing, hospitalized with a diagnosis of acute asthma exacerbation between 1995-1998 at the New York Hospital-Weill Cornell Medical Center and treated via the pathway, as well as a control group of 206 children ages 2-18 hospitalized for acute asthma exacerbation in 1994, the year prior to pathway implementation. Patients were treated via the pathway under the supervision of an asthma specialist. The pathway provided guidelines for: 1) frequency of patient assessment; 2) bronchodilator usage; 3) corticosteroid use; 4) laboratory evaluation; 5) vital signs, oxygen saturation, and peak flow measurements; 6) chest x-rays; 7) social work intervention; and 8) discharge planning. The main outcome measures were hospital length of stay, cost per hospitalization,nursing, medication, laboratory and radiology costs, and relapse rate. Total charges for admission and average LOS for 1995-1998 were calculated, andcompared with 1994, the year preceding implementation of the pathway. LOS decreased from 4.2 days to 2.7 days (P < 0.0001). The annual total charges for pediatric asthma admissions decreased from $2 million to $1.4 million (P < 0.005). Nursing and laboratory costs showed a statistically significant decrease. Follow-up study at 8 months showed a readmission rate of 0.02%. The implementation of a pediatric asthma clinical pathway, directed by specialists, resulted in significantly decreased length of stay and overall cost, without an increased rate of readmission. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 03:34:50