Implementation of an acute stroke program decreases hospitalization costs and length of stay

被引:129
作者
Wentworth, DA
Atkinson, RP
机构
[1] Mercy General Hospital, Sacramento, CA
[2] c/o Mercy General Hospital, Sacramento, CA 95819
关键词
cost and cost analysis; stroke management; outcome; stroke units; hospitalization;
D O I
10.1161/01.STR.27.6.1040
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose A large community hospital implemented an acute stroke program to respond to stroke patients in a consistent, systematic, and efficient manner. The primary objectives were to monitor the care delivered, improve the quality of care, and move the patients through their initial hospital stay in a timely manner. Methods Acute stroke standing orders were developed, with a critical path developed on the basis of these orders and an expected length of stay. A multidisciplinary team began the rehabilitation process early in the hospital stay, monitored patient progress and length of stay, and provided appropriate discharge placement. Retrospective chart reviews were performed over a 4-year period, and the data were collated on a yearly basis. Results Over a 4-year period, 414 Medicare patients demonstrated a steady decline of initial hospital length of stay from 7.0 to 4.6 days. During this same period of time, there was a decline in total hospital charges from $14076 to $10740 per patient. This represented a total dollar savings in charges of $1621296 (approximate to$453000 per year). The mortality rate for 1994 was 4.6%, with 46.5% of survivors discharged to home, 16.9% to acute rehabilitation, and 32.6% to nursing homes. Conclusions The implementation of a multidisciplinary acute stroke program decreased length of stay and hospitalization costs of Medicare patients.
引用
收藏
页码:1040 / 1043
页数:4
相关论文
共 5 条
[1]   GUIDELINES FOR THE MANAGEMENT OF PATIENTS WITH ACUTE ISCHEMIC STROKE - A STATEMENT FOR HEALTH-CARE PROFESSIONALS FROM A SPECIAL WRITING GROUP OF THE STROKE-COUNCIL, AMERICAN-HEART-ASSOCIATION [J].
ADAMS, HP ;
BROTT, TG ;
CROWELL, RM ;
FURLAN, AJ ;
GOMEZ, CR ;
GROTTA, J ;
HELGASON, CM ;
MARLER, JR ;
WOOLSON, RF ;
ZIVIN, JA ;
FEINBERG, W ;
MAYBERG, M .
STROKE, 1994, 25 (09) :1901-1914
[2]   EFFECT OF A STROKE PROTOCOL ON HOSPITAL COSTS OF STROKE PATIENTS [J].
BOWEN, J ;
YASTE, C .
NEUROLOGY, 1994, 44 (10) :1961-1964
[3]  
DOBKIN B, 1995, NEUROLOGY, V45, P6
[4]  
Gorelick P B, 1995, J Stroke Cerebrovasc Dis, V5, P1, DOI 10.1016/S1052-3057(10)80078-3
[5]  
MATCHAR DB, 1994, STROKE CLIN UPDATES, V5, P9