[Impact of a clinical pathway in cases of transurethral resection of the prostate]

Abstract

Objective: Because of recent increases in health care costs, cost containment has become a important issue in medical practice. We evaluated the effect on cost and clinical outcome with the implementation of clinical care pathway for transurethral resection of the prostate (TURP) patients.

Materials & methods: Our series consists of 69 consecutive patients treated with TURP between June 1, 1999 and March 31, 2000. The patients were divided into two groups at random. Thirty-two patients were treated on the clinical pathway (pathway group) and 37 patients were not placed on the clinical pathway program (non-pathway group). Total hospital charges, average length of stay and clinical outcomes were compared in two groups.

Results: The average of total hospital charges (insurance points) and average length of stay were 48,424.2 point, and 12.7 days for the pathway group, and 55.365.5 point, and 14.7 days for non-pathway group respectively. Postoperative complications and rehospitalization did not differ between two groups.

Discussion: With the implementation of the clinical care pathway, average hospital charges and length of stay were reduced. The clinical pathway program is considered to be a good tool for health care cost management. This methodology can be applied to all patients. However, when we make the clinical pathway program, we take into account the individuality of each patients.