NSQIP® 索引后的并发症 隔尿道膀瘤切除和当代的财务影响
Maxx K Caveney1,2, David C Brooks1,2, Devin A Haddad1,2
1Department of Urology (DCB, RCK, RPT), Wake Forest School of Medicine, Winston-Salem, North Carolina.
Urology practice
|June 14, 2023
概括
瘤大小会影响膀癌手术的结果和成本. 更大的瘤与增加的并发症,更长的住院时间和更高的成本相关,可能导致医院的财务损失.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 卫生经济学 卫生经济学
背景情况:
- 国家外科手术质量改善项目 (NSQIP) 提供了关于外科手术结果的宝贵数据.
- 了解瘤大小和并发症之间的关系对于患者护理和资源分配至关重要.
研究的目的:
- 为了确定NSQIP索引并发症的发病率,根据瘤大小在穿尿道膀瘤切除过程中.
- 通过使用当前的偿还计划,调查这些并发症的财务影响.
主要方法:
- 从2010-2012年对8,116个经尿道膀瘤切除的回顾性分析.
- 按瘤大小对手术进行分层,使用CPT代码.
- 使用统计测试对手术前特征,手术参数和30天结果进行比较.
- 分析机构财务数据和医疗保险退款计划.
主要成果:
- 较大的瘤切除与明显更长的手术时间,更长的住院时间以及更高的输血,败血症和功能不全率有关.
- 随着瘤大小的增加,观察到30天死亡率,再入院和重新手术的增加.
- 住院治疗的常见诊断相关分类导致医疗保险受益人的运营损失.
结论:
- 泌尿科医生选择的编码与NSQIP索引的术后并发症直接相关.
- 穿尿道膀瘤切除,特别是那些有并发症的切除,可能会导致医疗机构的财务损失.
- 改善护理质量和报销策略是解决这些财务挑战的必要条件.
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