Cost-effective standardization of preterm labor evaluation
Objective The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes. Study Design We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the May...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2010-09, Vol.203 (3), p.250.e1-250.e5 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Rose, Carl H., MD McWeeney, Dennis T., DO Brost, Brian C., MD Davies, Norman P., MBBS Watson, William J., MD |
| description | Objective The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes. Study Design We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay. Results Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900. Conclusion Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses. |
| doi_str_mv | 10.1016/j.ajog.2010.06.037 |
| format | Article |
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Study Design We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay. Results Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900. Conclusion Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2010.06.037</identifier><identifier>PMID: 20816147</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Cervical Length Measurement ; Cervix Uteri - diagnostic imaging ; Clinical Protocols ; cost ; Cost Savings ; Cost-Benefit Analysis ; Diseases of mother, fetus and pregnancy ; evaluation ; Female ; Fibronectins - analysis ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Obstetric Labor, Premature - diagnosis ; Obstetrics and Gynecology ; Patient Admission - economics ; Patient Admission - statistics & numerical data ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy. Fetus. Placenta ; Premature Birth - epidemiology ; Premature Birth - prevention & control ; preterm labor ; Retrospective Studies ; Triage</subject><ispartof>American journal of obstetrics and gynecology, 2010-09, Vol.203 (3), p.250.e1-250.e5</ispartof><rights>Mosby, Inc.</rights><rights>2010 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-79629261b9fa1f8bf1ad78b5ea13fc5da4a05dc40d131e4074c5cebac7fa4ad13</citedby><cites>FETCH-LOGICAL-c440t-79629261b9fa1f8bf1ad78b5ea13fc5da4a05dc40d131e4074c5cebac7fa4ad13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajog.2010.06.037$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>310,311,315,782,786,791,792,3552,23937,23938,25147,27931,27932,46002</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23227835$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20816147$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rose, Carl H., MD</creatorcontrib><creatorcontrib>McWeeney, Dennis T., DO</creatorcontrib><creatorcontrib>Brost, Brian C., MD</creatorcontrib><creatorcontrib>Davies, Norman P., MBBS</creatorcontrib><creatorcontrib>Watson, William J., MD</creatorcontrib><title>Cost-effective standardization of preterm labor evaluation</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes. Study Design We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay. Results Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900. Conclusion Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses.</description><subject>Biological and medical sciences</subject><subject>Cervical Length Measurement</subject><subject>Cervix Uteri - diagnostic imaging</subject><subject>Clinical Protocols</subject><subject>cost</subject><subject>Cost Savings</subject><subject>Cost-Benefit Analysis</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>evaluation</subject><subject>Female</subject><subject>Fibronectins - analysis</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Obstetric Labor, Premature - diagnosis</subject><subject>Obstetrics and Gynecology</subject><subject>Patient Admission - economics</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Premature Birth - epidemiology</subject><subject>Premature Birth - prevention & control</subject><subject>preterm labor</subject><subject>Retrospective Studies</subject><subject>Triage</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd-L1DAQgIMo3nr6D_ggfRGfujdJ06YVEWTxFxz4cOdzmCYTSe02a9Iu3P31pu6q4INPSWa-mQnfMPacw5YDb66GLQ7h21ZADkCzhUo9YBsOnSqbtmkfsg0AiLKrVHvBnqQ0rE_RicfsQkDLGy7Vhr3ehTSX5ByZ2R-pSDNOFqP19zj7MBXBFYdIM8V9MWIfYkFHHJdfuafskcMx0bPzecm-fnh_u_tUXn_5-Hn37ro0UsJcqq7JQxvedw65a3vH0aq2rwl55UxtUSLU1kiwvOIkQUlTG-rRKJdTOXjJXp36HmL4sVCa9d4nQ-OIE4UlaVVXXVdDJzMpTqSJIaVITh-i32O80xz0qkwPelWmV2UaGp2V5aIX5_ZLvyf7p-S3owy8PAOYDI4u4mR8-stVQqi2qjP35sRRlnH0FHUyniZD1sdsV9vg__-Pt_-Um9FPPk_8TneUhrDEKWvWXCehQd-s21x3y_Ol5UJWPwFZJ58y</recordid><startdate>20100901</startdate><enddate>20100901</enddate><creator>Rose, Carl H., MD</creator><creator>McWeeney, Dennis T., DO</creator><creator>Brost, Brian C., MD</creator><creator>Davies, Norman P., MBBS</creator><creator>Watson, William J., MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100901</creationdate><title>Cost-effective standardization of preterm labor evaluation</title><author>Rose, Carl H., MD ; McWeeney, Dennis T., DO ; Brost, Brian C., MD ; Davies, Norman P., MBBS ; Watson, William J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-79629261b9fa1f8bf1ad78b5ea13fc5da4a05dc40d131e4074c5cebac7fa4ad13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Biological and medical sciences</topic><topic>Cervical Length Measurement</topic><topic>Cervix Uteri - diagnostic imaging</topic><topic>Clinical Protocols</topic><topic>cost</topic><topic>Cost Savings</topic><topic>Cost-Benefit Analysis</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>evaluation</topic><topic>Female</topic><topic>Fibronectins - analysis</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Obstetric Labor, Premature - diagnosis</topic><topic>Obstetrics and Gynecology</topic><topic>Patient Admission - economics</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Premature Birth - epidemiology</topic><topic>Premature Birth - prevention & control</topic><topic>preterm labor</topic><topic>Retrospective Studies</topic><topic>Triage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rose, Carl H., MD</creatorcontrib><creatorcontrib>McWeeney, Dennis T., DO</creatorcontrib><creatorcontrib>Brost, Brian C., MD</creatorcontrib><creatorcontrib>Davies, Norman P., MBBS</creatorcontrib><creatorcontrib>Watson, William J., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rose, Carl H., MD</au><au>McWeeney, Dennis T., DO</au><au>Brost, Brian C., MD</au><au>Davies, Norman P., MBBS</au><au>Watson, William J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effective standardization of preterm labor evaluation</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2010-09-01</date><risdate>2010</risdate><volume>203</volume><issue>3</issue><spage>250.e1</spage><epage>250.e5</epage><pages>250.e1-250.e5</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective The purpose of this study was to determine the effect of a standardized evidence-based protocol for preterm labor evaluation on resource use and obstetrics outcomes. Study Design We conducted a retrospective 12-month observational study of patients with symptoms of preterm labor at the Mayo Clinic. All patients underwent triage evaluation per a standardized protocol with a combination of cervical length measurement with contingent fetal fibronectin assay. Results Of 201 patients who underwent evaluation, 3 women delivered within 7 days, and only 1 woman delivered after a negative evaluation. Mean gestational age at evaluation was 29 weeks 1 day, and delivery was at 38 weeks 3 days of gestation, with an average interval of 57.4 days until delivery. The rate of hospital admission was reduced by 56%, compared with the previous year; an estimated annual cost saving was $39,900. Conclusion Implementation of a standardized protocol for evaluation of preterm labor reduces the rate of unnecessary hospital admissions for observation with consequent significant reduction in expenses.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20816147</pmid><doi>10.1016/j.ajog.2010.06.037</doi><tpages>3</tpages></addata></record> |
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| subjects | Biological and medical sciences Cervical Length Measurement Cervix Uteri - diagnostic imaging Clinical Protocols cost Cost Savings Cost-Benefit Analysis Diseases of mother, fetus and pregnancy evaluation Female Fibronectins - analysis Gynecology. Andrology. Obstetrics Humans Medical sciences Obstetric Labor, Premature - diagnosis Obstetrics and Gynecology Patient Admission - economics Patient Admission - statistics & numerical data Pregnancy Pregnancy Complications - diagnosis Pregnancy. Fetus. Placenta Premature Birth - epidemiology Premature Birth - prevention & control preterm labor Retrospective Studies Triage |
| title | Cost-effective standardization of preterm labor evaluation |
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