Purpose: We assessed changes in hospital costs and resource use among
patients undergoing radical prostatectomy following implementation of
a clinical care path. Materials and Methods: A standardized clinical c
are path for patient management before and after radical prostatectomy
was developed and implemented at a large academic medical center in C
alifornia. All 577 consecutive patients undergoing radical prostatecto
my during the 3 years before and 1 year after implementation of the ca
re path were included in the study. Each patient was entered prospecti
vely into a hospital-wide financial data base, which served as the sou
rce for observations on hospital costs, hospital charges and length of
stay. Results: After implementation of the radical prostatectomy care
path hospital costs decreased by 12% ($7,916 versus $6,934, p <0.0001
), hospital charges decreased by 20% ($17,005 versus $13,524, p <0.000
1) and length of stay decreased by 28% (5 versus 3.6 days, p <0.0001).
Decreases were noted in all categories of the hospital patient financ
ial profile, except operating room charges. Conclusions: By standardiz
ing preoperative and postoperative management for patients undergoing
radical prostatectomy, significant savings can be achieved over and ab
ove existing trends toward shorter hospital stays and lower hospital c
osts.