在华盛顿州的炎症性肠病住院和手术的区域化特征
Stephanie L Stovall1, Celine R Soriano1, Jennifer A Kaplan1
1Department of Surgery, Virginia Mason Franciscan Health, 1100 9th Ave, C6-GS, Seattle, WA, 98101, USA.
概括
炎症性肠病 (IBD) 的住院病例大多是新兴和分散的. 选择性IBD手术集中在几个大量的中心,这表明护理中的区域化模式.
科学领域:
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
背景情况:
- 炎症性肠病 (IBD) 住院 represent 一个重要的医疗保健负担.
- 了解IBD护理中的区域化模式对于优化医疗保健利用至关重要.
研究的目的:
- 评估华盛顿州炎症性肠病 (IBD) 住院和外科手术的区域化模式.
- 描述IBD突发性和可选性诊断之间的差异及其相关程序.
主要方法:
- 从2008年到2019年使用华盛顿州综合医院摘要报告系统 (CHARS).
- 分析了20494例因克罗恩病 (CD) 和性结肠炎 (UC) 住院的病例.
- 医院住院的特点是根据急性 (紧急/选择性),手术 (手术/内镜),设施体积和患者旅行距离.
主要成果:
- 大多数 (78.2%) 的IBD住院是新出现的,发生在22个设施,通常是非手术.
- 选择性IBD住院 (71.1%) 集中在9个设施,其中78.5%涉及手术.
- 五家医院执行了所有可选IBD手术的69%;腹腔镜手术在紧急和可选手术中显著增加.
结论:
- 华盛顿州的IBD紧急住院治疗是分散的,通常是非手术性的.
- 涉及手术的可选IBD入院集中在高体积中心.
- 优化新出现的医疗和选择性手术IBD护理需要进一步了解住院的驱动因素.
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