@Article{chd.12508,
AUTHOR = {Rahul H. Rathod, Brittney Jurgen, Rose A. Hamershock, Kevin G. Friedman, Audrey C. Marshall, Mihail Samnaliev, Dionne A. Graham, Kathy Jenkins, James E. Lock, Andrew J. Powell},
TITLE = {Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {6},
PAGES = {768--776},
URL = {http://www.techscience.com/schd/v12n6/39219},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality
improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and
improve patient outcomes. We created a novel methodology, the SCAMP managed episode of
care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch
operation (ASO) SCAMP on total costs.<br/>
<b>Methods:</b> All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control
group of ASO patients (January 2001 to February 2009). Patients were divided into “younger” (<2
years) and “older” (2–18 years) subgroups. Utilization included all cardiology visits, tests, and procedures. Standardized costs were applied to each unit of utilization.<br/>
<b>Results:</b> There were 100 historical and 63 SCAMP patients in the younger subgroup, and 163 historical and 165 SCAMP patients in the older subgroup. In the younger subgroup, the SCAMP had
a 28% reduction in outpatient clinic visits (P < .001), a 52% reduction in chest radiographs
(P < .001), a 21% reduction in electrocardiograms (P< .001), and a 30% total reduction in costs. In
the older subgroup, the SCAMP had a 21% reduction in outpatient clinic visits (P< .001), a 20%
reduction in chest radiographs (P = .05), a 10% reduction in echocardiograms (P = .05), a 25%
reduction in exercise stress tests (P = .01), and a 14% total reduction in costs. The total cost savings of the ASO SCAMP was $216 649 in the first 6 years of the SCAMP. There was no
difference in clinical outcomes between the historical and SCAMP cohorts.<br/>
<b>Conclusion:</b> SCAMPs can improve resource utilization and reduce costs after the ASO operation
while maintaining quality of care.},
DOI = {10.1111/chd.12508}
}