An evidenced-based clinical pathway for acute appendicitis decreases hospital duration and cost

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B W Warner1, R M Kulick, M M Stoops

  • 1Division of Pediatric Surgery, Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH 45229, USA.

Journal of Pediatric Surgery
|October 10, 1998
PubMed

Insights

Implementing an evidence-based clinical pathway for acute appendicitis in children reduced hospitalization duration and costs. This approach improved patient care without compromising diagnosis or treatment outcomes.

Area of Science:

  • Pediatric Surgery
  • Healthcare Management
  • Clinical Pathways

Background:

  • Appendicitis is the most frequent surgical emergency in pediatric patients.
  • Effective management strategies are crucial for optimizing outcomes and resource utilization.

Purpose of the Study:

  • To evaluate the impact of an evidence-based clinical pathway for acute appendicitis.
  • To assess effects on patient care, hospital costs, and home care expenses in a pediatric institution.

Main Methods:

  • Prospective analysis of an appendicitis clinical pathway implemented from June to November 1996.
  • Comparison with historical control patients from June to November 1994.

Main Results:

  • Pathway patients showed similar rates of negative appendectomy and perforation compared to controls.
  • Non-perforated appendicitis pathway patients had earlier discharge (67% vs 48%) and lower costs ($3,638 vs $4,095).
  • Perforated appendicitis pathway patients experienced shorter hospitalizations (113 vs 185 hours) and reduced costs ($7,823 vs $11,175).

Conclusions:

  • An evidence-based appendicitis pathway effectively reduced hospitalization duration and costs.
  • The pathway did not adversely affect diagnostic accuracy or therapeutic effectiveness.
  • Clinical pathways offer a valuable tool for cost reduction in surgical care without compromising patient outcomes.
Abstract

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