田舎の中西部上部の軽度のTBI患者のケアによる臨床的および財政的な影響
Ryan Beard1, Nicole D Lee1, Khaled Zreik1,2
1Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
The American surgeon
|September 4, 2025
まとめ
重度のトラウマ性脳損傷 (BIG 1 TBI) を受けた田舎の患者は,生存率が改善されず,医療費が高くなります. 遠隔医療と標準化されたプロトコルは 費用を削減し 患者のケア効率を高めることができます
科学分野:
- トラウマ手術
- 医療管理
- 農村の健康
背景:
- 田舎の医療の格差は重度の脳外傷 (BIG 1 TBI) の患者の移送を必要としています.
- 臨床的衰退への恐れが 田舎の施設から 高等医療センターへの移転を促しています
研究 の 目的:
- 農村施設から移送されたBIG 1 TBI患者の費用と死亡率を 直接第三次医療センターに入院した患者と比較する.
- 患者と医療費への 移転プロトコルの影響を評価する.
主な方法:
- BIG 1 TBI患者の遡及コホート研究 (2020-2022)
- 移送された田舎の患者と直接入院した患者の比較
- 主要アウトカム分析:費用と死亡率;次要アウトカム分析:滞在期間と頭部CTスキャン
主要な成果:
- 移送された患者と直接入院したBIG 1 TBI患者の死亡率や入院期間には有意な違いはありません.
- 移植された患者は頭部CTスキャンを多く受けた (2. 5 対 2. 1).
- 移送された患者は,ネットワーク内 (13,956 ドル対 9,216 ドル) とネットワーク外 (20,041 ドル対 13,789 ドル) のコストが大幅に高かった.
結論:
- 田舎のBIG 1 TBI患者を移すことで 医療費は上がりますが 臨床的成果は改善されません
- 遠隔医療とプロトコルの介護は 農村部でのTBI管理のコスト削減と効率の向上の可能性を 提供しています
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