CLINICAL STRATEGIES TO REDUCE UTILIZATION OF CHEST PHYSIOTHERAPY WITHOUT COMPROMISING PATIENT-CARE

Background: There is widespread interest in the evaluation of clinical strategies that safely reduce health-care costs, Elimination of inapp ropriate chest physiotherapy may represent one of those strategies. Se tting: An academic community hospital. Methods: One-hundred one patien ts receiving chest physiotherapy were prospectively randomized to cont inue their chest physiotherapy or to inform their physicians that the order for the chest physiotherapy may have been inappropriate. Results : Patients who were randomized to have their chest physiotherapy disco ntinued received 45% fewer chest physiotherapy treatments than control patients (p<0.01). There was no increase in the mortality rate or len gth of hospital stay associated with the reduction in chest physiother apy in carefully selected patients, The estimated cost savings would b e $319,000, which is 50 times greater than the cost associated with th e intervention. Conclusion: Chest physiotherapy is frequently provided to patients for inappropriate indications. Reducing chest physiothera py for these patients may significantly reduce respiratory therapy cos ts without increasing length of stay or mortality rates.