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紧急手术,多病症和没有住院的日子:一项回顾性观察性研究
Claire B Rosen1, Sanford E Roberts1, Chris J Wirtalla2
1Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Center for Surgery and Health Economics, Perelman School of Medicine, Philadelphia, Pennsylvania.
The Journal of surgical research
|August 9, 2023
概括
紧急通用外科患者的多病症与较少的无住院日 (HFD) 有关. 这种以患者为中心的结果在非手术治疗中尤为明显,突出显示了康复的差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 老年医学 老年医学
背景情况:
- 无医院日 (HFD) 为评估医疗保健结果提供以患者为中心的指标.
- 多病症,即多种慢性疾病的存在,显著影响患者的康复和医疗利用率.
研究的目的:
- 调查紧急整体外科 (EGS) 患者的多病症和HFD之间的关联.
- 为了比较多病症和非多病症EGS患者之间的HFD,手术治疗与非手术治疗.
主要方法:
- 对EGS患者的国家医疗保险索赔数据 (2015-2018) 的回顾性分析.
- 根据符合条件的并发症组,将患者分类为多病症患者.
- 在180天内计算HFD并使用多变量回归模型进行比较.
主要成果:
- 多种疾病患者占EGS手术队伍的45.5%,非手术队伍的59.2%.
- 与非多重病症患者相比,多重病症患者在手术组 (6.5天少) 和非手术组 (7.9天少) 的HFD显著减少.
- 即使调整了停留时间,这些发现仍然存在,特别是在非操作性集团中.
结论:
- 在基于索赔的研究中,HFD作为一种有价值的以患者为中心的结果衡量标准.
- 多病症与EGS患者在医院外的时间减少有关.
- 具有多病症的EGS患者的非手术治疗可能会导致长时间住院和更少的HFD.
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