评估门诊外科中心的体积-结果协会
Siddharth Jain1, Paul R Rosenbaum2,3, Joseph G Reiter1
1Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia.
JAMA surgery
|January 24, 2024
概括
门诊外科手术中心 (ASC) 的手术量较少,与7天的复诊率增加有关,特别是在多病症患者中. 与外科医生讨论护理位置对于有多种健康状况的老年患者至关重要.
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
- 健行护理服务提供者
背景情况:
- 较高的医院手术量与更好的外科手术结果有关.
- 在美国的门诊外科手术中心 (ASC) 中,体积与结果的关联尚未得到广泛研究.
研究的目的:
- 为了确定低体积的ASC是否在手术后7天内有更高的患者复诊率.
- 调查这种关联是否在多病症患者中更明显.
主要方法:
- 使用2018-2019年医疗保险索赔数据进行匹配的病例控制研究.
- 分析了2,328名ASC和4,751名患者,7天的再访 (病例) 与23,755名对照进行了匹配.
- 定义低体积的ASC在2年内执行<50次手术;高体积的ASC执行≥50次手术.
主要成果:
- 低体积ASC的患者有更高的7天复诊几率 (OR,1.21).
- 患有多病症的患者在低体积的ASC有明显更高的复诊几率 (OR,1.57).
- 在多病症患者中,在低体积的ASC中进行的骨科手术显示复诊率高出84% (OR,1.84).
结论:
- 在ASC中,手术体积是患者结果的重要指标.
- 低体积的ASC与7天内复诊率的增加有关,特别是在多病症患者中.
- 患有多种疾病的老年患者应与外科医生讨论最佳的外科护理设置.
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