Kazuaki Kuwabara1, Yuichi Imanaka, Tatsuro Ishizaki. 1. Kyoto University, Graduate School of Medicine, School of Public Health, Department of Healthcare Economics and Quality Managment, Sakyo-ku, Kyoto, Japan.
Abstract
OBJECTIVES: The surgical management and outcome of outpatient care for patients with simple lacerations were compared across three institutions. We examined the variations in wound infection rate, total charge and medical resource use in terms of prophylactic antibiotic prescription, frequency of outpatient visits and required days for stitch removal. DESIGN: Retrospective and consecutive chart review. STUDY PARTICIPANTS: Patients receiving treatment for simple lacerations in the outpatient departments of three institutions in Japan between June 2000 and August 2001. OUTCOME MEASURES AND METHOD: The basic patient characteristics, treatment method for the laceration and incidence of wound infection were collected. Variations in the wound infection rate were examined across the institutions. We then examined the variations in the medical resource use and total charge for patients without wound infection among the institutions by multiple linear regression model. RESULTS: A total of 479 patients were reviewed. The proportion of patients with blunt injury, patients with simple lacerations to the head or face, and those with underlying medical disease were significantly different among the three institutions. The wound infection rate did not significantly differ (1.9% in Institution A, 1.3% in B, 3.0% in C, P = 0.555). The medical resource use for patients without wound infection was significantly different and small in Institution A. CONCLUSION: We identified variations in the resource use for completing wound care among three institutions, whereas the wound infection rate revealed no significant difference among the institutions. There existed some room for improvement in the productive efficiency of simple laceration treatment.
OBJECTIVES: The surgical management and outcome of outpatient care for patients with simple lacerations were compared across three institutions. We examined the variations in wound infection rate, total charge and medical resource use in terms of prophylactic antibiotic prescription, frequency of outpatient visits and required days for stitch removal. DESIGN: Retrospective and consecutive chart review. STUDY PARTICIPANTS: Patients receiving treatment for simple lacerations in the outpatient departments of three institutions in Japan between June 2000 and August 2001. OUTCOME MEASURES AND METHOD: The basic patient characteristics, treatment method for the laceration and incidence of wound infection were collected. Variations in the wound infection rate were examined across the institutions. We then examined the variations in the medical resource use and total charge for patients without wound infection among the institutions by multiple linear regression model. RESULTS: A total of 479 patients were reviewed. The proportion of patients with blunt injury, patients with simple lacerations to the head or face, and those with underlying medical disease were significantly different among the three institutions. The wound infection rate did not significantly differ (1.9% in Institution A, 1.3% in B, 3.0% in C, P = 0.555). The medical resource use for patients without wound infection was significantly different and small in Institution A. CONCLUSION: We identified variations in the resource use for completing wound care among three institutions, whereas the wound infection rate revealed no significant difference among the institutions. There existed some room for improvement in the productive efficiency of simple laceration treatment.
Authors: Roman Povolotskiy; Nakul Gupta; Adam B Leverant; Aron Kandinov; Boris Paskhover Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-02-01 Impact factor: 6.223