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首页> 美国政府科技报告 >Impact of Early Discharge Following Bypass Surgery Final rept. (Jan. 1, 2000-Aug. 31, 2004)
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Impact of Early Discharge Following Bypass Surgery Final rept. (Jan. 1, 2000-Aug. 31, 2004)

机译：旁路手术后早期出院的影响最终评估。 （2000年1月1日 - 2004年8月31日）

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We characterized trends in post-operative length of stay following bypass surgery and assessed the effect of shorter stays on clinical outcomes (readmission/death) and cost within 60 days of discharge. Bypass surgery patients in New York state (1992-1998) and Alabama (= 65 years, 1995- 1998) were included. Clinical data were obtained from the York Cardiac Surgery Reporting System and the Alabama Quality Assurance Foundation CABG Cooperative database. Follow-up health care use was obtained from New York state and Medicare claims. Early discharge (ED) was defined on a patient-specific basis using 1995 norms. Logistic regression was used to examine the effect of ED on outcomes. The relation between outcomes and ED at the hospital level was also examined. The effect of ED on inpatient, outpatient, skilled nursing and home health costs within 60 days of discharge was assessed using regression analysis. Between 1996 and 1998, 17% of patients in New York and 19% in Alabama were discharged early. Freedom from readmission/death after 60 days was 80% in New York and 77% in Alabama. After adjusting for baseline risk, patients discharged early were less likely to die or be readmitted (New York OR=.84, Alabama OR=.78, p<.001). Patients discharged earlier also had lower costs in the subsequent 60 days. This finding suggests that physicians are able to select low risk candidates for ED and that shorter stays have not compromised patient outcomes. Furthermore, savings from ED have not been offset by increases in downstream costs.

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