在微创性妇科瘤手术后增强康复的成本影响分析
Cristina Mitric1,2, Sarah Daisy Kosa3, Soyoun Rachel Kim1,2
1Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health System, Toronto, Ontario, Canada.
概括
手术后增强恢复 (ERAS) 计划显著降低了微创性妇科瘤手术的成本. 这项质量改进计划将患者的整体成本降低了1000多美元,证明了经济效益以及更好的出院率.
科学领域:
- 妇科瘤学 妇科瘤学
- 在外科手术期间的护理.
- 卫生经济学 卫生经济学
背景情况:
- 手术后增强恢复 (ERAS) 原则越来越多地被采用在微创性妇科瘤手术中.
- 之前的研究表明,ERAS计划可以改善患者的治疗结果,例如当天出院率.
- 在这一特定的外科患者群体中实施ERAS计划的经济影响需要详细分析.
研究的目的:
- 评估一个基于ERAS的近期手术护理计划对微创性妇科瘤手术的经济影响.
- 通过分析整体,手术和术后访问费用来确定ERAS实施的成本效益.
主要方法:
- 一个使用ERAS原则的质量改进计划被实施,用于最小侵入性切除子宫的患者.
- 在12个月的时间内,将干预前队列与干预后队列进行了比较.
- 总体成本,手术访问成本 (手术前,手术室,手术后停留,药房,干预) 和手术后30天访问成本 (诊所,急诊室,再入院) 的数据在2020 CAD.中收集和分析.
主要成果:
- 干预后组 (101名患者) 的平均总成本为7252美元,而干预前组 (96名患者) 的总成本为8381美元,每名患者减少了1129美元 (p=0.02).
- 在手术后停留 (816美元对1278美元,p<0.05),手术访问,手术室费用和药房费用方面,观察到显著的成本降低.
- 多变量分析表明,手术方法和干预组 (前与后) 影响了整体和术后停留费用.
结论:
- 基于ERAS的术后护理计划的实施大大降低了与微创性妇科瘤手术相关的成本.
- 该计划为每位患者节省了大量的成本,同时提高了当天出院率 (从29%提高到75%).
- 埃拉斯计划代表了一种具有成本效益的策略,用于加强妇科瘤学的术后护理.
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