Introduction of Critical Path Guidlines into Cases Performed Distal Gastrectomy.

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  • 幽門側胃切除術に対するクリティカル・パスの導入経験

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Abstract

To prepare for the change in the health insurance system in Japan, critical path guidelines have been introduced to our hospital. In our surgical department, critical path for distal gastrectomy has also been inducted since autumn in 1998. To evaluate the effect of the induction, days in hospital and points for health insurance were compared between 10cases treated using the critical path guidelines and 17cases without critical path. The path prescribes the clinical course as follows: preoperative exam at outpatient clinic, 2days stay befor operation, 16days stay after operation. As a result, about 70% of patients followed this path. The average hospital stay has significantly decreased from 36to 27.3days after induction of the path. Average points for health insurance also significantly decreased from 165, 800to 133, 900. Adjusting points by days in hospital to 19days, showed that the medical care itself was also standardized under the critical path.

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