Literature DB >> 28660735

Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

Rahul H Rathod1,2, Brittney Jurgen1,2, Rose A Hamershock3, Kevin G Friedman1,2, Audrey C Marshall1,2, Mihail Samnaliev4, Dionne A Graham3, Kathy Jenkins1,2, James E Lock1,2, Andrew J Powell1,2.   

Abstract

BACKGROUND: Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs.
METHODS: All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (<2 years) and "older" (2-18 years) subgroups. Utilization included all cardiology visits, tests, and procedures. Standardized costs were applied to each unit of utilization.
RESULTS: There were 100 historical and 63 SCAMP patients in the younger subgroup, and 163 historical and 165 SCAMP patients in the older subgroup. In the younger subgroup, the SCAMP had a 28% reduction in outpatient clinic visits (P < .001), a 52% reduction in chest radiographs (P < .001), a 21% reduction in electrocardiograms (P < .001), and a 30% total reduction in costs. In the older subgroup, the SCAMP had a 21% reduction in outpatient clinic visits (P < .001), a 20% reduction in chest radiographs (P = .05), a 10% reduction in echocardiograms (P = .05), a 25% reduction in exercise stress tests (P = .01), and a 14% total reduction in costs. The total cost savings of the ASO SCAMP was $216 649 in the first 6 years of the SCAMP. There was no difference in clinical outcomes between the historical and SCAMP cohorts.
CONCLUSION: SCAMPs can improve resource utilization and reduce costs after the ASO operation while maintaining quality of care.
© 2017 Wiley Periodicals, Inc.

Entities:  

Keywords:  congenital heart disease; cost reduction; resource utilization; standardization

Mesh:

Year:  2017        PMID: 28660735     DOI: 10.1111/chd.12508

Source DB:  PubMed          Journal:  Congenit Heart Dis        ISSN: 1747-079X            Impact factor:   2.007


  4 in total

1.  Feasibility of Transthoracic Echocardiography Evaluation of Pulmonary Arteries Following Arterial Switch Operation.

Authors:  Sean M Lang; R Lee Crawford; Pushpa Shivaram; Joshua A Daily; Elijah H Bolin; Xinyu Tang; R Thomas Collins
Journal:  Pediatr Cardiol       Date:  2018-06-07       Impact factor: 1.655

2.  The Limited Benefit of Follow-Up Echocardiograms After Repair of Tetralogy of Fallot.

Authors:  Jack Xu; Caleb Guthrey; Stephen Dalby; Xinyu Tang; Joshua Daily; R Thomas Collins
Journal:  Pediatr Cardiol       Date:  2019-09-18       Impact factor: 1.655

3.  Practice Variation in Establishing the Adequacy of Beta-Blockers as an Antiarrhythmic Agent in School-Aged Children and Adolescents.

Authors:  Hilal Al Riyami; Arif Hussain; Andrew Warren; Santokh S Dhillon
Journal:  CJC Open       Date:  2020-03-27

Review 4.  Improving Long-Term Outcomes After Extracorporeal Membrane Oxygenation: From Observational Follow-Up Programs Toward Risk Stratification.

Authors:  Hanneke IJsselstijn; Maayke Hunfeld; Raisa M Schiller; Robert J Houmes; Aparna Hoskote; Dick Tibboel; Arno F J van Heijst
Journal:  Front Pediatr       Date:  2018-06-26       Impact factor: 3.418

  4 in total

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