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Effects of morning report case presentation on length of stay and hospitalisation costs.
Med Educ. 2013 Jul;47(7):711-6
Authors: Boushehri E, Khamseh ME, Farshchi A, Aghili R, Malek M, Ebrahim Valojerdi A
Abstract
CONTEXT: The primary goal of discussing patient cases during the morning report is to teach appropriate clinical decision making. In addition, the selection of the best diagnostic strategy and application of evidence-based patient care are important. Reducing hospital costs is fundamental to controlling inflation in health care costs, especially in university hospitals that are subject to budget constraints in developing countries. The goal of this study was to explore the effect of morning report case presentation on length of stay (LoS) and hospitalisation costs in a university teaching hospital.
METHODS: A total of 54 patients whose cases had been presented at morning report sessions in the department of internal medicine during a 3-month period (presented group) were selected and their medical records reviewed for data on final diagnosis, hospital LoS and detailed hospital costs. A control group of 104 patients, whose cases had not been presented, were selected on the basis that their final diagnoses matched with those of the presented group. In addition, the groups were matched for age, sex, occupation, comorbidities and insurance coverage. Final diagnoses were based on International Classification of Disease 10 (ICD-10) diagnostic code criteria.
RESULTS: The mean ± standard deviation (SD) hospital LoS was 8.32 ± 4.11 days in the presented group and 10.46 ± 4.92 days in the control group (p = 0.045). Mean ± SD hospitalisation costs per patient were significantly lower in the presented group (US$553.43 ± 92.16) than the control group (US$1621.93 ± 353.14) (p = 0.004). Although costs for paraclinical services were similar, there were very significant reductions in costs for medications used during hospitalisation and bed-days (p = 0.002).
CONCLUSIONS: Discussing clinical aspects of patient cases in morning report sessions facilitates the management process and has a significant effect on LoS and hospitalisation costs in patients admitted to hospital.
PMID: 23746160 [PubMed - indexed for MEDLINE]