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在肝胰腺手术和术后结果中的护理碎片化
Zayed Rashid1, Muhammad Musaab Munir2, Selamawit Woldesenbet3
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH. Electronic address: http://www.twitter.com/ZRashidMD.
Surgery
|April 2, 2024
概括
分碎的外科实践与患者的治疗结果更差和成本更高有关,无论外科医生的数量如何. 女性外科医生表现出更高的实践分散率,影响护理质量和开支.
科学领域:
- 手术质量和患者的结果.
- 医疗服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 在外科手术中实践的碎片化可能会损害护理质量.
- 了解实践碎片化,外科医生特征和患者结果之间的关系至关重要.
研究的目的:
- 为了定义碎片化实践与肝胰腺外科手术结果之间的关联.
- 调查外科医生体积和性别对这种关联的影响.
主要方法:
- 分析了接受肝胰腺手术 (2016-2021) 的医疗保险受益人.
- 多变量分析评估了提供者基于性别的差异,包括分散的实践,教科书成果和医疗保健支出,并根据外科医生病例数量进行调整.
主要成果:
- 女性外科医生有较高的碎片化实践率 (84.9%vs78.4%).
- 分碎的实践与术后并发症增加,住院时间长,90天死亡率高,教科书结果的几率降低有关.
- 这些关联无论外科医生的数量如何,都持续存在,对男性外科医生的教科书结果产生了显著影响.
- 较高的碎片化做法与医疗保健支出增加相关 (9.87%的差异).
结论:
- 高水平的碎片化外科实践会对术后结果和医疗保健支出产生负面影响.
- 碎片化的实践对结果的影响因外科医生的性别而异,即使在大量的外科医生中也是如此.
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