| Autor: |
Patrick B. Murphy, Dave Paskar, Richard Hilsden, Jennifer Koichopolos, Tina S. Mele, on behalf of Western Ontario Research Collaborative on Acute Care Surgery |
| Jazyk: |
angličtina |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
World Journal of Emergency Surgery, Vol 12, Iss 1, Pp 1-8 (2017) |
| Druh dokumentu: |
article |
| ISSN: |
1749-7922 |
| DOI: |
10.1186/s13017-017-0128-3 |
| Popis: |
Abstract Background Modern practice guidelines recommend index cholecystectomy (IC) for patients admitted with gallstone pancreatitis (GSP). However, this benchmark has been difficult to widely achieve. Previous work has demonstrated that dedicated acute care surgery (ACS) services can facilitate IC. However, the associated financial costs and economic effectiveness of this intervention are unknown and represent potential barriers to ACS adoption. We investigated the impact of an ACS service at two hospitals before and after implementation on cost effectiveness, patient quality-adjusted life years (QALY) and impact on rates of IC. Methods All patients admitted with non-severe GSP to two tertiary care teaching hospitals from January 2008–May 2015 were reviewed. The diagnosis of GSP was confirmed upon review of clinical, biochemical and radiographic criteria. Patients were divided into three time periods based on the presence of ACS (none, at one hospital, at both hospitals). Data were collected regarding demographics, cholecystectomy timing, resource utilization, and associated costs. QALY analyses were performed and incremental cost effectiveness ratios were calculated comparing pre-ACS to post-ACS periods. Results In 435 patients admitted for GSP, IC increased from 16 to 76% after implementing an ACS service at both hospitals. There was a significant reduction in admissions and emergency room visits for GSP after introduction of ACS services (p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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