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Related Experiment Videos

An internist joins the surgery service: does comanagement make a difference?

D S Macpherson1, C Parenti, J Nee

  • 1Department of Medicine, University of Pittsburgh, Pennsylvania.

Journal of General Internal Medicine
|August 1, 1994
PubMed
Summary

Adding an internist to cardiothoracic surgery teams reduced hospital stays and resource use. This intervention may improve patient outcomes, warranting further study in diverse settings.

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Area of Science:

  • Medical intervention and healthcare management
  • Surgical patient care optimization

Background:

  • Cardiothoracic surgery patients often have complex medical needs requiring specialized care.
  • Integrated care models can potentially improve patient outcomes and resource efficiency.

Purpose of the Study:

  • To evaluate the impact of internist comanagement on cardiothoracic surgical patients.
  • To assess effects on patient outcomes and healthcare resource utilization.

Main Methods:

  • A before-and-after study design was employed at a tertiary care Veterans Affairs hospital.
  • 165 patients undergoing cardiothoracic surgery were analyzed (86 pre-intervention, 79 post-intervention).
  • Comanagement involved a dedicated internist seeing patients preoperatively through discharge.

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Main Results:

  • Significant reductions observed in postoperative length of stay (18.1 to 12.1 days) and total length of stay (27.2 to 19.7 days).
  • In-hospital mortality decreased from 8.1% to 2.5%, though not statistically significant (p=0.17).
  • Significant decrease in X-ray utilization (p=0.02) and near-significant decrease in laboratory test use (p=0.06).

Conclusions:

  • Internist comanagement in cardiothoracic surgery is associated with reduced resource utilization and potentially improved outcomes.
  • Further investigation with robust study designs is recommended to validate these findings in other healthcare settings.