Cost-Efficient Radical Prostatectomy with a Clinical Care Path

Abstract

Purpose We assessed changes in hospital costs and resource use among patients undergoing radical prostatectomy following implementation of a clinical care path. Materials and Methods A standardized clinical care path for patient management before and after radical prostatectomy was developed and implemented at a large academic medical center in California. All 577 consecutive patients undergoing radical prostatectomy during the 3 years before and 1 year after implementation of the care path were included in the study. Each patient was entered prospectively into a hospital-wide financial data base, which served as the source for observations on hospital costs, hospital charges and length of stay. Results After implementation of the radical prostatectomy care path hospital costs decreased by 12 percent ($7,916 versus $6,934, p less than 0.0001), hospital charges decreased by 20 percent ($17,005 versus $13,524, p less than 0.0001) and length of stay decreased by 28 percent (5 versus 3.6 days, p less than 0.0001). Decreases were noted in all categories of the hospital patient financial profile, except operating room charges. Conclusions By standardizing preoperative and postoperative management for patients undergoing radical prostatectomy, significant savings can be achieved over and above existing trends toward shorter hospital stays and lower hospital costs.