(Stroke. 1996;27:1040-1043.)
© 1996 American Heart Association, Inc.
Articles |
Implementation of an Acute Stroke Program Decreases Hospitalization Costs and Length of Stay
From Mercy General Hospital, Sacramento, Calif.
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 (
$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.
Key Words: cost and cost analysis • stroke management • outcome • stroke units • hospitalization
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