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PubMed · 10345339

NICU care redesigned using outcomes chain approach to analyzing, using data.

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Abstract

Outcomes chain in practice: Hospital saves an astounding $90,000 in costs per preterm CV patient. When researchers at an IHC hospital found they could change the way preterm babies are ventilated and avoid the lung injuries caused by conventional ventilation, they drilled down into the process of caring for these patients and found hundreds of other opportunities for change. Mini-teams handled individual processes, flow-charting them, asking how and why at each step, gathering data, making changes, and measuring outcomes.

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Cost SavingsData CollectionHumansInfant, NewbornIntensive Care, NeonatalOrganizational InnovationOutcome and Process Assessment, Health CarePatient Care TeamQuality of Health CareUtahUtilization ReviewJournal Article

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1997. NICU care redesigned using outcomes chain approach to analyzing, using data.. https://pubmed.ncbi.nlm.nih.gov/10345339/

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We developed a decision-analytic model to examine the economic impact of shifting the locus of care for patients with painful neuropathies from specialists to GPs. The impetus for such a shift was assumed to be a formal education program, focusing on the recognition and treatment of neuropathic pain, conducted for GPs. In the model, all patients with neuropathic pain were assumed to initiate care with their GPs and then be referred to specialists and, ultimately, pain clinics as required for adequate pain control. Two alternative scenarios were examined--the "current" arrangement in which most patients were assumed to be referred for treatment by specialists and pain clinics and a "hypothetical" arrangement in which GPs were assumed to play an expanded role in the treatment of neuropathic pain and which, therefore, often precluded the need for referral. The model was populated with clinical, epidemiologic, and economic data from Norway. A total of 34,951 persons in Norway were estimated to seek care for painful neuropathies each year. The formal education program was assumed to cost 1.5 million Kroner (NOK). Shifting the locus of care from specialists to GPs would result in 4,715 additional GP visits, but 12,123 fewer specialist visits and 7,967 fewer visits to pain clinics. This change would result in estimated savings to the Norwegian health-care system in 2004 of 74.1 million NOK (approx. US $11.9 million). A partial shift in the locus of care of painful neuropathies from specialists to GPs may result in substantial cost savings to the Norwegian health-care system.

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