EFFECT OF THE INTRODUCTION OF A CRITICAL PATH FOR PRIMARY LUNG CANCER ANALYZED BY THE RELATIONSHIP BETWEEN THE HOSPITAL STAY AND MEDICAL REWARD

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  • NAKAMURA Hiroshige
    Department of Chest Surgery, National Hospital Organization Yonago Medical Center
  • NITTA Susumu
    Department of Chest Surgery, National Hospital Organization Yonago Medical Center
  • FUKUI Hajime
    Department of Chest Surgery, National Hospital Organization Yonago Medical Center

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  • 在院日数と診療報酬の相関関係からみた肺癌クリティカルパスの導入効果
  • ザイイン ニッスウ ト シンリョウ ホウシュウ ノ ソウカン カンケイ カラ ミタ ハイガン クリティカルパス ノ ドウニュウ コウカ

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We analyzed the improvement in hospital management with the progression of critical path of the operation for primary lung cancer, especially noting the relationship between hospital stay and medical reward. One hundred twenty operated cases of primary lung cancer from September 2000 to June 2003 were selected to compare the number of patients, duration of drainage, postoperative hospital stay, total hospital stay and medical reward per day among three groups for each one year period using without critical path, with induction critical path and revised critical path.<br>The results showed the increasing number of patients, shortness of the duration of drainage, postoperative hospital stay, total hospital stay and the increasing medical reward per day. The comparison of the background of each group revealed the recent progression of thoracoscopic surgery. However, because exclusion of the factor of thoracoscopic surgery also showed the same results as the previous analysis, it is indicated that the progression of the critical path is resulting in improvement of staff consciousness and technical capability, which is contributing to hospital management.<br>The relationship between the hospital stay and medical reward had a significant correlation and the increasing of a slant is recognized with the progression of our critical path. These might result from the high cost of thoracoscopic surgery compared to open surgery and positive impact on the length of hospital stay. Regarding the postoperative adjuvant therapy, the medical reward gradually reduces with the length of the hospital stay. The analysis of the relationship between the hospital stay and medical reward could also be very useful to compare the differences in each disease and institution.

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