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Health resource utilization and quality of life outcomes of low-risk coronary artery bypass graft patients: a
1School of Nursing, Faculty of Health Sciences, University of Western Ontario, London. tumblrok@sprynet.com
Insights
A clinical path for coronary artery bypass graft (CABG) surgery patients reduced hospital stays without impacting quality of life (QOL). Health resource utilization showed mixed results, with fewer clinic visits for those in the preadmission program.
Area of Science:
- Cardiovascular Surgery
- Health Services Research
Background:
- Coronary artery bypass graft (CABG) surgery improves quality of life (QOL) but incurs significant costs.
- A clinical path was developed at University Campus, London Health Science Centre (UC-LHSC) to reduce CABG costs via shorter hospital stays for low-risk patients.
Purpose of the Study:
- To compare health resource utilization (HRU) and QOL outcomes between traditional CABG care and a new clinical path.
- To evaluate HRU and QOL 6 to 12 months post-discharge.
Main Methods:
- Comparative study of low-risk CABG patients.
- Assessment of HRU (emergency visits, office visits, home care, hospital admissions) and QOL.
- Evaluation of a preadmission program within the clinical path group.
Main Results:
- No significant differences in QOL were found between the clinical path and traditional care groups at 6 months post-CABG.
- The clinical path group had more emergency department visits but similar rates of other HRU categories compared to the control group.
- Patients in the clinical path group who received the preadmission program had fewer extra office/clinic visits.
Conclusions:
- A shorter hospital stay for low-risk CABG patients via a clinical path is feasible without compromising QOL.
- The preadmission program component of the clinical path may further optimize health resource utilization.
- Findings contribute to understanding the impact of shortened hospital stays on CABG patients and healthcare systems.
Abstract:
Coronary artery bypass graft surgery (CABG), undertaken because of a decline in quality of life (QOL), is known to decrease morbidity and mortality, but it is expensive. At University Campus, London Health Science Centre, (UC-LHSC), a clinical path for CABG patients categorized as low-risk by UC-LHSC was developed to decrease the costs of CABG surgery through a shortened hospital stay while maintaining quality of patient care. The purpose of this research was to compare traditional care of the CABG patient with the care of those on the Clinical Path for Coronary Artery Bypass Graft Patients on health resource utilization (HRU) and QOL outcomes 6 to 12 months post surgical discharge. The results of this study showed that while the experimental group made significantly more emergency department visits than did the control group, the groups did not differ on the health resource utilization categories of extra office visits, home care, or hospital admission. It was also found that within the experimental (Clinical Path) group there were significantly fewer extra office or clinic visits required by the subjects who received the Preadmission Program than by the participants who did not receive this program. No differences were found in quality of life 6 months after CABG surgery between low-risk patients receiving traditional care and those patients on the CABG Clinical Path. Results of this study have increased understanding of the impact of a shorter hospital stay upon CABG patients and on the health care system.