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The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

Publication ,  Journal Article
Englesbe, MJ; Grenda, DR; Sullivan, JA; Derstine, BA; Kenney, BN; Sheetz, KH; Palazzolo, WC; Wang, NC; Goulson, RL; Lee, JS; Wang, SC
Published in: Surgery
June 2017

BACKGROUND: The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. METHODS: We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015. Propensity score matching was used to match program participants to a control group who underwent operative care prior to program implementation. Primary outcome measures were hospital duration of stay and payer costs. Multivariate regression was used to determine the covariate-adjusted effect of program participation. RESULTS: A total of 641 patients participated in the program; 82% were actively engaged in the program, recording physical activity at least 3 times per week for the majority of the program; 182 patients were propensity matched to patients who underwent operative care prior to program implementation. Multivariate analysis demonstrated that participation in the Michigan Surgical Home and Optimization Program was associated with a 31% reduction in hospital duration of stay (P < .001) and 28% lower total costs (P < .001) after adjusting for covariates. CONCLUSION: A home-based, preoperative training program decreased hospital duration of stay, lowered costs of care, and was well accepted by patients. Further efforts will focus on broader implementation and linking participation to postoperative complications and rigorous patient-reported outcomes.

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Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

June 2017

Volume

161

Issue

6

Start / End Page

1659 / 1666

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Surgery
  • Propensity Score
  • Program Evaluation
  • Program Development
  • Preoperative Care
  • Multivariate Analysis
  • Middle Aged
  • Michigan
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Englesbe, M. J., Grenda, D. R., Sullivan, J. A., Derstine, B. A., Kenney, B. N., Sheetz, K. H., … Wang, S. C. (2017). The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs. Surgery, 161(6), 1659–1666. https://doi.org/10.1016/j.surg.2016.12.021
Englesbe, Michael J., Dane R. Grenda, June A. Sullivan, Brian A. Derstine, Brooke N. Kenney, Kyle H. Sheetz, William C. Palazzolo, et al. “The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.Surgery 161, no. 6 (June 2017): 1659–66. https://doi.org/10.1016/j.surg.2016.12.021.
Englesbe MJ, Grenda DR, Sullivan JA, Derstine BA, Kenney BN, Sheetz KH, et al. The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs. Surgery. 2017 Jun;161(6):1659–66.
Englesbe, Michael J., et al. “The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.Surgery, vol. 161, no. 6, June 2017, pp. 1659–66. Pubmed, doi:10.1016/j.surg.2016.12.021.
Englesbe MJ, Grenda DR, Sullivan JA, Derstine BA, Kenney BN, Sheetz KH, Palazzolo WC, Wang NC, Goulson RL, Lee JS, Wang SC. The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs. Surgery. 2017 Jun;161(6):1659–1666.
Journal cover image

Published In

Surgery

DOI

EISSN

1532-7361

Publication Date

June 2017

Volume

161

Issue

6

Start / End Page

1659 / 1666

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Surgery
  • Propensity Score
  • Program Evaluation
  • Program Development
  • Preoperative Care
  • Multivariate Analysis
  • Middle Aged
  • Michigan
  • Male