时间驱动活动为基础的成本分析尿路结石疾病的时间驱动活动
Matthew E Pollard1, Aaron A Laviana1, Alan L Kaplan1
1Department of Urology, UCLA David Geffen School of Medicine, Los Angeles, California.
Urology practice
|June 14, 2023
概括
保守的石头管理比结石的手术干预要便宜得多. 灵活的尿路透镜是最昂贵的手术选择,突出了泌尿器科护理成本改善的领域.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 卫生经济学 卫生经济学
- 腎石病的管理方法
背景情况:
- 美国结石发病率的增加带来了重大的经济挑战.
- 基于时间驱动的活动成本计算 (TDABC) 是分析医疗保健成本的有效方法.
- 本研究使用TDABC来评估四种常见的结石治疗方法.
研究的目的:
- 描述和比较四种结石治疗方法的成本.
- 确定每个治疗方法的主要成本驱动因素.
- 为未来的泌尿器科石材护理成本效益分析提供信息.
主要方法:
- 使用过程映射来详细评估,治疗和对结石 (<10毫米) 的随访.
- 根据资源利用 (设备,一次性物品,人员,空间) 和时间计算成本.
- 分析了四种治疗方法:通过试验,半刚性尿路透镜,灵活的尿路透镜和体外冲击波石.
主要成果:
- 试验通道 (389美元) 是最便宜的,主要是由于诊所访问费用.
- 手术干预的费用各不相同:体外冲击波光 (4367美元),半刚性尿路透镜 (4830美元) 和柔性尿路透镜 (5356美元).
- 术内一次性设备和人员成本是外科手术治疗总体开支的最大贡献者.
结论:
- 对结石的保守管理比手术选择更具成本效益.
- 灵活的尿路透镜在评估的手术干预中占最高成本.
- 这项TDABC分析提供了有关成本驱动因素的宝贵见解,有助于提高泌尿器科护理的价值和成本效益.
相关概念视频
01:30Urinary Tract Calculi III: Medical Management
9
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
9
01:25Urinary Tract Calculi VI: Surgical Management
11
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
11
01:28Urinary Tract Calculi V: Nursing Management
14
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
14
01:28Urinary Tract Calculi I: Introduction
19
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
19
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
11
Management of renal calculi focuses on effective strategies like tailored nutrition and hydration therapy. Adjusting diet and fluid intake reduces stone formation and recurrence, making these interventions simple yet powerful in kidney stone prevention and management.Understanding Kidney StonesKidney stones form when calcium, oxalate, uric acid, and cystine concentrate and crystallize in urine. Factors contributing to their formation include genetic predisposition, certain medical conditions,...
11
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
16
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
16