在经过明智选择十年后,低风险白内障手术的常规预手术护理的患病率和成本
Jillian M Rung1, Oluseyi Aliu2, Tyson S Barrett1
1Highmark Health, Pittsburgh, Pennsylvania.
Ophthalmology
|December 13, 2023
概括
在白内障手术前进行例行手术前检查和评估仍然很常见,尽管有减少不必要手术的举措. 这些耗资数百万美元的做法与较少的不良事件没有相关性,可能需要对政策进行审查.
科学领域:
- 眼科医生 眼科 眼科
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- "明智选择"运动旨在减少不必要的医疗检查和手术.
- 像白内障手术这样的低风险手术的常规术前护理一直是控制成本的重点.
研究的目的:
- 分析手术前清除测试和低风险白内障手术检查的频率,成本和预测因素.
- 为了确定手术前护理是否影响术后不良事件.
主要方法:
- 从商业医疗保健组织的医疗保健索赔和医疗记录的回顾性分析.
- 包括在2018-2021年期间接受白内障手术的65岁以上的持续注册会员.
- 使用程序和诊断代码识别手术前护理;根据索赔估计成本和患病率;对接受护理和不良事件进行预测建模.
主要成果:
- 高达42%的患者进行了手术前检查,23%的患者进行了检查,耗资430万美元.
- 手术设施和护理团队是手术前护理的关键预测因素,设施对测试更强大.
- 副作用很少见,与手术前评估或测试的程度无关.
结论:
- 自从"明智选择"运动以来,白内障手术的例行手术前检测的发生率并没有显著下降.
- 术前评估是常见的,可能是不必要的,这表明需要重新考虑当前的政策.
- 设施级实践似乎是术前护理利用的重要驱动因素.
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