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Use of outpatient preoperative evaluation to decrease length of stay for vascular surgery

J B Pollard1, P Garnerin, R L Dalman

  • 1Veterans Affairs Palo Alto Health Care System, CA 94304, USA. JB4Pollard@aol.com

Anesthesia and Analgesia
|December 9, 1997
PubMed
Summary
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Outpatient preoperative evaluation significantly reduces hospital length of stay for carotid endarterectomy and lower extremity revascularization. This approach saves costs without impacting patient outcomes.

Area of Science:

  • Vascular Surgery
  • Health Services Research

Background:

  • Reducing perioperative length of stay is crucial for cost containment in healthcare.
  • Vascular surgical procedures like carotid endarterectomy (CEA) and lower extremity revascularization (LER) are candidates for streamlining preoperative processes.

Purpose of the Study:

  • To evaluate the impact of implementing an outpatient preoperative evaluation clinic on length of stay and hospital costs for CEA and LER patients.
  • To determine if same-day admission following outpatient evaluation affects patient outcomes.

Main Methods:

  • A comparative study analyzing patient data from one year before and one year after the introduction of an outpatient preoperative evaluation clinic.
  • Patient demographics, American Society of Anesthesiologists (ASA) physical status, and length of stay were compared between the two periods.

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  • Cost savings were calculated based on the reduction in length of stay.

    • Main Results:

    • No significant differences in mean age or ASA physical status were observed between the pre- and post-implementation groups for CEA and LER.
    • The average preoperative length of stay decreased significantly: from 7.0 to 1.9 days for CEA and from 9.0 to 2.8 days for LER.
    • This reduction in stay resulted in an estimated cost saving of $900 per patient.

    Conclusions:

    • Outpatient preoperative evaluation and same-day admission effectively reduce the preoperative length of stay for vascular surgery patients undergoing CEA and LER.
    • The implemented changes led to substantial cost savings without compromising patient safety or outcomes.
    • Outpatient preoperative evaluation clinics represent a viable strategy for improving efficiency and reducing costs in vascular surgery.