美国的性结肠炎非选择性手术的成本变化
Ayesha P Ng1, Nikhil Chervu1, Giselle Porter1
1Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, California, United States.
概括
对于性结肠炎 (UC) 手术的医院费用有很大的不同. 优化手术时间和集中在高人数中心的护理可以降低开支并提高UC手术护理的价值.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 卫生经济学 卫生经济学
背景情况:
- 尽管生物疗法取得了进展,但性结肠炎 (UC) 的手术费用继续上升.
- 目前缺乏UC手术护理的综合性成本分析.
- 这项研究调查了非选择性UC切除后住院费用的风险因素和中心水平变化.
研究的目的:
- 分析性结肠炎 (UC) 的非选择性手术的成本.
- 确定影响这些成本的患者和医院因素.
- 评估医院规模的影响,并确定高成本医院 (HCHs).
主要方法:
- 利用了2016-2020年全国再接收数据库,用于接受非选择性切除术或直肠切除术的成人UC患者.
- 采用混合效应模型来确定住院费用的患者和医院预测因素.
- 根据风险调整成本对医院进行排名,以确定高成本医院 (HCH),并分析其结果.
主要成果:
- 医院住院费用的中位数指数为40300美元,估计有10280名患者.
- 增加手术的时间与更高的成本 (2500美元/天) 相关联.
- 较高的医院数量与成本降低相关 (- $5900为中等, - $8200为高).
- 医院间的差异占成本差异的19.2%.
- 高血压患者出现并发症增加 (AOR 1.39),逗留时间长 (+10.1天),非家庭出院率更高 (AOR 1.78),尽管死亡率和再入院率相似.
结论:
- 与非选择性UC手术相关的成本存在医院一级的显著差异.
- 优化外科手术时间和将护理区域化到更大体积的中心是提高UC手术护理价值的潜在策略.
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