Variation in Care Processes in Patients undergoing Hernia Repair – An Eight Hospital Study

Halmerbauer, G. (Speaker)

Activity: Talk or presentationOral presentation

Description

VARIATION IN CARE PROCESSES IN PATIENTS UNDERGOING HERNIA REPAIR - AN EIGHT HOSPITAL STUDY Halmerbauer-G (1), Arthofer-K (1), Ausch-C (2), Ehrenmüller-M (1), Hangl C (1), Hubatka-K (1), Kamptner-N (1), Königswieser-T (3), Rieger-R (3) 1. Department of Process Management in Health Care, University of Applied Sciences Upper Austria, Steyr, Austria 2. Department of Surgery, Central Hospital Steyr, Steyr, Austria 3. Department of Surgery, Central Hospital Salzkammergut, Gmunden, Austria ABSTRACT Introduction: The routine use of laboratory and radiologic investigations prior and post-surgery is considered an important element of care by patients as well as by physicians. As herniotomy is one of the most frequent reasons for abdominal surgery, each element of care needed for diagnosis and treatment should be considered carefully as it adds to the physician’s work load and to costs. There are evidence-based guidelines for hernia repair as well as for preoperative evaluation, detailing the use of laboratory tests. It has been demonstrated that based on such guidelines patient care could be standardized. Variation in care processes may be caused by different factors. It is often argued that differences in patient risk are an important source of variation. Objective: The aim of this retrospective study was to examine different patterns of ordering for radiologic and laboratory services in eight hospitals concerning patients undergoing hernia repair, classified as ASA I without complications before, during and after their hospital stay. Methods: The study was conducted at eight small to medium -sized Austrian hospitals in Upper Austria (154 to 601 beds). Resource use for laboratory and radiologic testing was analyzed with a random sample of 451 patients classified as ASA I without complications undergoing hernia repair. Data about laboratory and radiologic procedures of the patients was abstracted from administrative databases during the patients’ stay in hospital as well as during a time span covering 42 days before and after the stay. Statistical differences between the hospitals were calculated with the Kruskal-Wallis test. Results: The participating hospitals performed a median (Q1-Q3) of 7 (6-23) to 36 (34-36) laboratory tests per patient before, during and after the stay. Furthermore, a median (Q1-Q3) of 0 (0-0) to 4 (2-6) radiologic services per patient was carried out. The surgical wards the patients were treated in differed significantly concerning the numbers of laboratory (p
Period26 Apr 2015
Event title1st World Conference on Abdominal Wall Hernia Surgery: null
Event typeWorkshop
LocationMailand, Italy