Perioperative surgical home model reduces LOS
Model for inpatient urologic procedures also yields significantly lower complication rate
The perioperative surgical home (PSH) is a promising model for delivering high-quality, cost-effective care for patients undergoing inpatient urologic procedures, according to the experience of urologists from Loma Linda University, Loma Linda, CA.
At the 2016 World Congress of Endourology in Cape Town, South Africa, they reported findings from a retrospective study that examined the impact of PSH implementation on patient outcomes and institutional direct costs. The study included data for patients undergoing robotic radical cystectomy; open and robotic partial nephrectomy; and open, laparoscopic, and robotic radical nephrectomy from January 2014 through March 2016. The PSH was introduced in January 2015, and there were 118 patients in the pre-PSH cohort and 193 patients managed through the PSH model.
Compared to the pre-PSH group, patients operated on after implementation of the PSH had a significantly shorter average length of stay (3.19 vs. 4.79 days; p=.00) and a significantly lower complication rate (5.7% vs. 15.3%; p=.00). There was no significant difference in the readmission rate for the PSH and pre-PSH groups (5.7% vs. 5.9%; p=.93).
In a multivariate analysis accounting for a significantly lower rate of open procedures in the PSH group, PSH was identified as an independent factor accounting for the decrease in length of stay. Factoring in that the average length of stay was reduced by about 1.5 days for the 193 patients in the PSH cohort, it was determined that the PSH model reduced direct hospital costs by over $1.2 million.