Implementation of an Acute Stroke Program Decreases Hospitalization Costs and Length of Stay

作者：Deidre Wentworth, Richard P. Atkinson · 发表于：Stroke · 年份：1996 · DOI：10.1161/01.str.27.6.1040 · 被引用次数：156 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Frailty in Older Adults

BACKGROUND AND PURPOSE: A large community hospital implemented an acute stroke program to respond to stroke patients in a consistent, systematic, and efficient manner. The primary objectives were to monitor the care delivered, improve the quality of care, and move the patients through their initial hospital stay in a timely manner. METHODS: Acute stroke standing orders were developed, with a critical path developed on the basis of these orders and an expected length of stay. A multidisciplinary team began the rehabilitation process early in the hospital stay, monitored patient progress and length of stay, and provided appropriate discharge placement. Retrospective chart reviews were performed over a 4-year period, and the data were collated on a yearly basis. RESULTS: Over a 4-year period, 414 Medicare patients demonstrated a steady decline of initial hospital length of stay from 7.0 to 4.6 days. During this same period of time, there was a decline in total hospital charges from $14,076 to $10,740 per patient. This represented a total dollar savings in charges of $1,621,296 (approximately $453,000 per year). The mortality rate for 1994 was 4.6%, with 46.5% of survivors discharged to home, 16.9% to acute rehabilitation, and 32.6% to nursing homes. CONCLUSIONS: The implementation of a multidisciplinary acute stroke program decreased length of stay and hospitalization costs of Medicare patients.