Care pathway reduces hospitalizations and cost for hemodialysis vascular access surgery

摘要: Hemodialysis vascular access-related hospitalizations account for more than 20% of United States end-stage renal disease (ESRD) hospitalizations, with an annual cost approximating $675 million. Limiting costs while delivering similar degrees quality care thus would enhance alternative utilization ESRD funding. We implemented a access pathway emphasizing coordinated patient evaluation and outpatient surgery to determine whether such intervention affected outcomes associated surgery. Data examining hospitalization charges, complications, satisfaction (determined by questionnaire) were analyzed, comparing patients who underwent in 1994 1995 as inpatients (non-care patients) via the 1995. Inpatient days declined (1994: 582 days; 1995: 85 P < 0.03) average charges per cohort significantly less non-care (1994 patients: $10,524 ± $5,209; $11,196 $5,806; $4,686 $2,912/patient; 0.02). Incidence rates major (life-threatening) complications not different between However, had higher incidence (15.4%). Forty-seven repeat procedures performed 29 versus 35 22 1995, 12 eight Finally, majority entered into responded survey stated that they satisfied pathway. These data suggest can reduce hospital achieving acceptable