幽門側胃切除クリニカルパスの導入効果と問題点

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  • REDUCED DURATION OF HOSPITAL STAY BY IMPLEMENTATION OF A CLINICAL PATHWAY FOR DISTAL GASTRECTOMY

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[Purpose] The objective of this study was to evaluate the effects of clinical pathway implementation in patients undergoing distal gastrectomy for gastric cancer. [Methods] Surgical outcomes were compared between consecutive 105 patients undergoing distal gastrectomy (DG) before implementation of a clinical pathway (PrePath) from January to September 2002 and consecutive 102 patients after the implementation (PostPath) from January to September 2003. [Results] Mean durations of total hospital stay and postoperative hospital stay were significantly reduced in PostPath patients compared with PrePath patient (22 vs. 20 days; p<0.0001, 14 vs. 12 days; p<0.0001). Similarly, mean total medical expenses were also significantly reduced in PostPath patients (¥1232290 vs. ¥1158020; p<0.0001). [Conclusions] The implementation of a clinical pathway for DG patients effectively reduced the duration of hospital stay and medical expenses. A problem that the implementation did not shorten preoperative hospital stay became apparent. Further analyses of outcomes and resultant improvement of clinical pathway would be necessary.

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