常规的术后实验室和医疗保健系统在急性尾炎中的负担
Joshua A Sznol1, Robert Becher1, Adrian A Maung1
1Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA.
American journal of surgery
|June 8, 2023
概括
在急性尾炎 (AA) 管理中的例行术后实验室检测增加了医疗保健成本,但没有改善患者的结果. 重新评估这种做法可以减少不必要的支出和系统负担.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 手术管理的手术管理.
- 实验室医学 实验室医学
背景情况:
- 医疗保健成本正在上升,与此同时,实验室测试的可用性也在增加.
- 高效的资源利用对于降低医疗保健成本至关重要.
- 在急性尾炎 (AA) 管理中的例行术后实验室检测可能会增加成本和医疗保健系统负担.
研究的目的:
- 评估在无并发性急性尾炎中常规术后实验室使用的成本效益.
- 为了确定手术后的实验室测试是否会影响AA患者的临床结果.
主要方法:
- 对没有并发症的AA患者进行回顾性队列研究 (2016-2020年).
- 收集的数据包括临床变量,人口统计,实验室使用,干预和相关成本.
- 使用多变量建模来评估实验室利用率与结果之间的关联.
主要成果:
- 总共分析了3711名没有并发症的AA患者.
- 手术后的实验室费用为289505美元,补充费用为1287.63.5美元.
- 住院时间 (LOS) 的增加与实验室利用率有关,每名患者的成本增加了472.12美元.
结论:
- 在这个AA患者队列中,术后实验室检测增加了成本,但没有明显的临床益处.
- 应重新评估在伴随性疾病最小的患者的例行术后实验室检查.
- 消除不必要的实验室测试可以降低医疗保健成本并改善资源配置.
相关概念视频
Appendicitis-II: Diagnostic Studies and Management
104
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
104
Appendicitis-I: Introduction
289
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
289
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
128
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
128
Aneurysm IV: Nursing Management
11
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
11
Peripheral Artery Disease V: Postoperative Nursing Management
13
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
13
Acute Pyelonephritis II: Diagnostic Studies and Management
19
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
19


