Faculty Collaboration Database

Multidisciplinary approach decreases length of stay and reduces cost for ventricular assist device therapy. Interact Cardiovasc Thorac Surg 2009 Jan;8(1):84-8

Date

10/23/2008

Pubmed ID

18940829

DOI

10.1510/icvts.2008.187377

Scopus ID

2-s2.0-58149391573 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

High implantation costs and long postoperative length of stay (LOS) in debilitated patients complicate ventricular assist device (VAD) therapy. Between July 2000 and February 2005, 30 patients received a VAD at our institution. Of those, 20 patients were successfully discharged from the hospital with VADs. In August 2003, a multidisciplinary team was formed consisting of all services for VAD patients to replace a single-discipline (cardiac surgery) system. This team evaluated potential VAD candidates and identified optimal timing for implantation. These 20 VAD patients were divided into two groups according to the initiation of multidisciplinary team; the traditional group (n=7, July 2000-July 2003) and the multidisciplinary group (n=13, August 2003-February 2005). Patient demographics were not different. The LOS decreased from 61 to 15 days (P<0.01), especially LOS on the floor decreased from 35 to 7 days (P=0.03). The floor cost was significantly reduced ($47,111 vs. $8742, P<0.01), leading to a decrease in total postoperative cost ($202,238 vs. $161,744, P<0.01). The 30-day readmission rate decreased (5/7 patients vs. 1/13 patients, P<0.01). A multidisciplinary approach significantly decreased LOS and cost after VAD therapy, mostly by decreasing the cost of routine non-ICU care, without increasing the readmission rate.

Author List

Murray MA, Osaki S, Edwards NM, Johnson MR, Bobadilla JL, Gordon EA, Sanderfoot M, Kohmoto T

Author

Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cost Savings
Female
Heart Failure
Heart-Assist Devices
Hospital Costs
Humans
Length of Stay
Male
Middle Aged
Patient Care Team
Patient Discharge
Patient Readmission
Postoperative Care
Program Evaluation
Retrospective Studies
Treatment Outcome