Acute nonvariceal upper gastrointestinal (GI) bleeding is the most common medical emergency encountered by gastroenterologists. It results in high patient morbidity and cost.
In this study, physicians from Cleveland, Ohio determined whether a GI bleeding clinical care pathway could improve the quality and cost effectiveness of inpatient medical care.
|The use of radiological tests, time to endoscopy, and length of stay remained unchanged.|
|American Journal of Gastroenterology|
The team established a disease management program for acute upper GI bleeding.
They noted patients' length of stay, time to endoscopy, utilization of radiological tests, acid suppression, and cost of care before and after initiation of the program.
The physicians found that the GI bleeding management program significantly reduced the use of intravenous H2-blockade from 65% to 48%.
However, the use of radiological tests, time to endoscopy, and length of hospital stay remained unchanged.
The team found that there was a trend toward a reduction in total cost and variable direct cost per patient, from $5381 to $4627 and from $2269 to $1952, respectively.
Dr Patrick Pfau's team concluded, "A clinical care pathway may affect the management of acute upper GI bleeding and reduce costs".
"However, there are significant limitations and barriers to the overall effectiveness of such a pathway in actual clinical practice".