同一天出院的结肠手术:在经济上值得吗?
Karleigh R Curfman1, Gabrielle E Blair2, Callan L Kosnik1
1MultiCare Health Network, Tacoma, Washington, USA.
概括
结直肠外科手术的同日出院 (SDD) 与术后第一天 (POD1) 的出院相比,显著降低了医院费用. 临床结果和贡献幅度在两种排放策略之间仍然可比.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 医疗保健经济学 医疗保健经济学
背景情况:
- 经过手术后改善的恢复方案和最少的侵入性技术增加了结直肠手术当天出院 (SDD) 的可行性.
- 随着COVID-19的流行,医院资源的有效利用的必要性进一步凸显出来,这使得SDD成为一个相关的考虑因素.
研究的目的:
- 为了比较同一天出院的临床结果和财务影响 (SDD) 与结直肠外科手术的术后第一天 (POD1) 出院.
- 分析SDD和POD1排放组之间的成本,费用,收入和贡献率差异.
主要方法:
- 在2年的时间里,对143名胆管切除术患者进行了回顾性审查.
- 患者被分为两个组:SDD (n=51) 和POD1分泌 (n=92).
- 数据使用国际疾病统计分类和相关健康问题-10 (ICD-10) 和诊断相关群组 (DRG) 代码进行分析.
主要成果:
- 与POD1出院相比,SDD与统计学上显著较低的总医院费用 (8699美元 vs. 11,652美元) 和平均费用 (85,506美元 vs. 97,008美元) 相关.
- 两组之间在净收入,贡献率,手术室时间,机器人控制台时间,再入院率或手术并发症方面没有发现统计学意义上的差异.
- SDD显示了较低的平均医院成本和费用,这表明了潜在的财务利益.
结论:
- 结直肠外科手术的同日出院 (SDD) 与手术后的第一天 (POD1) 出院相比,与降低的医院费用和费用有关.
- SDD提供了可比的临床结果,包括再入院率和手术并发症,以POD1释放.
- 对于结直肠外科手术患者来说,SDD是一个经济可行的和临床安全的选择,特别是在与流行病相关的限制范围内.
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