Document Detail

Reduction of hospital stay and cost after the implementation of a clinical pathway for radical gastrectomy for gastric cancer.
MedLine Citation:
PMID:  18595014     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Clinical pathways have been used for various surgical procedures to improve outcomes and reduce costs. Radical gastrectomy is a major surgery for the treatment of gastric cancer. This study serves to evaluate the difference in clinical outcomes before and after patients were managed on a multidisciplinary gastrectomy pathway. METHODS: Between 2000 and 2005, 115 consecutive patients who underwent gastrectomy were categorized into a pre-pathway group and a pathway group. This corresponded to the implementation of the clinical pathway in August 2002. The 61 patients in the pathway group were managed according to a multidisciplinary program, while the 54 patients in the pre-pathway group were managed conventionally. The clinical outcomes and hospital costs were then assessed and compared. RESULTS: The two groups were similar in terms of demographics, comorbidities, types of gastrectomies, and pathological cancer staging. The postoperative length of hospital stay (LOS) was 9 days for the pathway group and 11 days for the pre-pathway group (P=0.02), and the total LOS in the two groups was 11 and 14 days, respectively (P=0.02). The cost of hospitalization for the pathway patients was S$13 338, which was significantly lower compared to the S$17 371 cost for the pre-pathway patients (P=0.047). CONCLUSION: Clinical pathways may reduce hospital stay and costs for patients undergoing gastrectomy for the treatment of gastric cancer.
Jimmy B Y So; Ziliang L Lim; Heng-An Lin; Thiow-Kong Ti
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Publication Detail:
Type:  Journal Article     Date:  2008-07-02
Journal Detail:
Title:  Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association     Volume:  11     ISSN:  1436-3291     ISO Abbreviation:  Gastric Cancer     Publication Date:  2008  
Date Detail:
Created Date:  2008-07-02     Completed Date:  2008-11-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886238     Medline TA:  Gastric Cancer     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  81-5     Citation Subset:  IM    
Department of Surgery, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Lower Kent Ridge Road, 119072, Singapore, Singapore.
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MeSH Terms
Critical Pathways / economics*
Gastrectomy / economics*
Length of Stay* / economics
Middle Aged
Patient Readmission
Stomach Neoplasms / economics*,  surgery*

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