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小児手術施設の集中に対する親の好み: 離散選択実験からの洞察
Kengo Hattori1,2, Kentaro Hayashi3, Shinsuke Ikeda4
1Department of Pediatric Surgery, Takatsuki General Hospital, 1-3-13, Kosobe-cho, Takatsuki-shi, Osaka, 569-1192, Japan. ken5hattori@gmail.com.
Pediatric surgery international
|August 24, 2025
まとめ
集中治療を考える際には 親は直接的な臨床成果よりも より多くの外科医や 緊急事態の対応などの 改善された小児外科施設の構造を優先します 医療の質を向上させるために 旅行時間を犠牲にする意思を示しています
科学分野:
- 小児外科
- 医療サービス研究
- 健康 経済
背景:
- 小児手術施設を集中化することで 治療の質は向上しますが 患者の移動時間は長くなることがあります
- 施設の位置とサービスのデザインを最適化するには 両親の好みを理解することが重要です
研究 の 目的:
- 小児外科施設の集中化による利益と,アクセシビリティの低下による影響の間のトレードオフを量化する.
- 小児手術の様々な特徴に対する 親の好みを評価する.
主な方法:
- 新生児の親を対象に別々の選択実験が行われました.
- 仮説的な施設は,外科医の数,緊急対応 (EC),手術容量,移動時間,専門家の可用性,高度な能力,合併症率,および主治医のシステムなど,さまざまな属性で提示されました.
- 旅行時間に関する優先順位と限界代用率を推定した.
主要な成果:
- 親の好みは,外科医の数,EC,年間手術量,移動時間によって大きく影響を受けた.
- 外科医の数を増やし,ECの強化は高く評価され,受け入れ可能な移動時間の大幅な増加に相当しました.
- 高い手術容量と専門医と高度な手術能力の利用も好まれていましたが,より低い合併症率とチームベースの治療はより少ない効果でした.
結論:
- 親は一般的に小児外科施設の集中を支持しています.
- 外科医の数を増やし 緊急事態対策の強化といった 構造的な改善は 合併症率などの直接的な臨床結果よりも優先されます
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