This article is more than 5 years old. Information may no longer be current.
Implementation of fast tracking in congenital heart surgery saved time, money
Click Here to Manage Email Alerts
The implementation of fast tracking for children undergoing congenital heart disease surgery at a single center was associated with shorter length of stay and cost savings, according to data published in Circulation: Cardiovascular Quality & Outcomes.
Researchers at Mount Sinai Medical Center compared administrative data on patients aged 2 months to 19 years who underwent surgery for atrial septal defect (ASD; n=77) or ventricular septal defect (VSD; n=89). These data were compared with information on children undergoing ASD surgery (n=3,103) or VSD surgery (n=4,180) at 40 US centers included in the Pediatric Health Information System. The researchers examined 3-year blocks, before and after fast tracking was implemented at Mount Sinai Medical Center.
Median length of stay at Mount Sinai Medical Center was reduced by 1 day after fast tracking was fully implemented. Length of stay was 1 day for ASD surgery and 3 days for VSD surgery, on average. At the national centers without fast tracking, median length of stay did not change (3 days for ASD surgery and 4 days for VSD surgery).
At Mount Sinai Medical Center, hospitalization costs were reduced by one-third (33% for ASD, 35% for VSD), but increased at national centers by 16% and 17%, respectively.
Multiple regression model analyses indicate the decrease in length of stay and cost remained significantly greater at Mount Sinai Medical Center compared with the national centers (P<.0001 for all). Hospital mortality and 2-week readmission rates remained the same at Mount Sinai Medical Center before and after fast tracking, and did not differ from the national rates.
“To the best of our knowledge, this is the first study to examine the economic and safety implications of introducing fast tracking into pediatric cardiothoracic surgical practice by comparing the detected changes with corresponding changes in a large number of contemporary programs in the United States,” the researchers wrote. “… These findings confirm and validate reports from single-center studies and mirror similar reports from adult cardiac surgery.”
For more information:
Lawrence EJ. Circ Cardiovasc Qual Outcomes. 2013;6:201-207.
Disclosure: This study was supported by intramural departmental funding. The researchers report no relevant financial disclosures.