Elective home replacement of gastrostomy feeding tubes is safe and cost-effective. Has hospital referral become obsolete?
| Autor: | Pietro Fusaroli, Elena Teci, Andrea Lisotti, Anna Cominardi, Giovanni Mangano |
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| Přispěvatelé: | Cominardi, Anna, Lisotti, Andrea, Teci, Elena, Mangano, Giovanni, Fusaroli, Pietro |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Referral Cost-Benefit Analysis Percutaneous endoscopic gastrostomy medicine.medical_treatment Enteral feeding Gastrostomy feeding Health Services Accessibility 03 medical and health sciences Enteral Nutrition 0302 clinical medicine Home health Health care Protocol Humans Medicine In patient Prospective Studies Adverse effect Aged Aged 80 and over Gastrostomy Hepatology business.industry General surgery Healthcare Gastroenterology Home Care Services Parenteral nutrition 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business Home replacement |
| Zdroj: | Digestive and Liver Disease. 53:620-624 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2020.12.004 |
| Popis: | Background Percutaneous endoscopic gastrostomy (PEG) is the technique of choice for providing enteral nutrition in patients with functioning gastrointestinal tract. Available guidelines cover indications and procedural management for PEG placement, while there is no consensus about subsequent replacement with gastrostomy feeding tubes (GFT) and their management. We hypothesized that GFT replacement, according to a standardized protocol supervised by a trained gastroenterologist could be integrated into the home health care system. Aims To evaluate the safety and cost-efficacy of home GFT replacement. Methods All consecutive patients who underwent elective home GFT replacements from July 2016 to December 2019 were prospectively enrolled; all procedural details and outcomes have been recorded. Results Overall, 235 GFT replacements in 84 patients [40.5% male, 79.5 (74–94) years] were included. Among these, 230 (97.8%) were completed at patients’ home while in five cases (2.2%) patients were referred to the hospital to confirm appropriate GFT placement. No adverse event occurred. An overall cost reduction of 46.8% was obtained, leading to €124 savings per procedure and up to €29,000 savings for the entire study period. Conclusions When performed electively according to a standardized protocol, home GFT replacement is safe and effective, and leads to relevant cost reduction. |
| Databáze: | OpenAIRE |
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