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Impact of the integrated comprehensive care program post-thoracic surgery: A propensity score-matched study
Negar Ahmadi1, Lawrence Mbuagbaw2, Christian Finley1
1Division of Thoracic Surgery, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
The Journal of Thoracic and Cardiovascular Surgery
|July 28, 2020
Summary
The Integrated Comprehensive Care (ICC) program significantly reduced hospital length of stay, emergency department visits, and readmissions for thoracic surgery patients. This patient-centered approach also showed a trend toward decreased postoperative mortality.
Area of Science:
- Thoracic Surgery Outcomes
- Patient-Centered Care Models
- Postoperative Management
Background:
- Thoracic surgery carries high risks of postoperative complications and readmissions.
- Effective strategies are needed to improve postdischarge outcomes for these patients.
Purpose of the Study:
- To evaluate the impact of the Integrated Comprehensive Care (ICC) program on postdischarge outcomes.
- To compare outcomes of thoracic surgery patients in the ICC program versus routine care.
Main Methods:
- Retrospective cohort study of 1288 lung malignancy resection patients (2010-2014).
- Comparison between ICC intervention cohort (2012-2014) and routine care control cohort (2010-2012).
- Propensity score matching used to create comparable cohorts; outcomes assessed included LOS, ED visits, readmissions, and mortality within 60 days.
Main Results:
- The ICC cohort (n=478) demonstrated significantly shorter length of stay (4 vs. 5 days, P=.001).
- ICC patients had fewer 60-day emergency department visits (9.8% vs. 28.4%, P<.001) and readmissions (6.9% vs. 8.6%, P<.001).
- A significant reduction in 60-day mortality was observed in the ICC cohort (0.6% vs. 0.8%, P<.001).
Conclusions:
- The Integrated Comprehensive Care program is effective in improving postoperative outcomes for thoracic surgery patients.
- ICC is associated with reduced length of stay, fewer emergency department visits, and lower readmission rates.
- The program shows potential to decrease postoperative mortality in thoracic surgery.
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