Compliance and efficiency before and after implementation of a clinical practice guideline for laryngeal carcinomas.
Eur Arch Otorhinolaryngol
; 263(8): 729-37, 2006 Aug.
Article
em En
| MEDLINE
| ID: mdl-16699832
ABSTRACT
We evaluated whether the implementation of a nationwide clinical practice guideline for diagnosis, treatment and follow-up of laryngeal carcinomas led to changes in hospital costs, balanced against clinical changes observed following the guideline's implementation. Charts of 822 patients with larynx carcinoma (459 treated before the introduction of the guideline and 363 thereafter) in five hospitals were retrospectively investigated. In all phases, no differences in total hospital costs were observed after the guideline's implementation. Total mean costs were Euro 3,207 (95%CI 3,091-3,395) for diagnosis, Euro 3,169 (2,153-4,182), Euro 5,026 (3,996-6,057), Euro 6,458 (5,579-7,337), Euro 8,037 (7,469-8,606), Euro 12,765 (10,763-14,769), Euro 19,227 (16,848-21,605) for treatment of dysplasia, carcinoma in situ, T1, T2, T3 and T4 carcinoma, respectively, and Euro 1,856 (1,491-2,220) for 1 year disease-free follow-up. In an earlier study, we observed several positive changes after the guideline's implementation. Balanced against the equal costs before and after the guideline's implementation, we conclude that the efficiency of the care process improved.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carcinoma in Situ
/
Carcinoma de Células Escamosas
/
Neoplasias Laríngeas
/
Serviço Hospitalar de Oncologia
/
Guias de Prática Clínica como Assunto
/
Custos Hospitalares
/
Fidelidade a Diretrizes
Tipo de estudo:
Diagnostic_studies
/
Evaluation_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur Arch Otorhinolaryngol
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Holanda