在医院和独立的外科中心的价格和并发症
James C Robinson1, Christopher M Whaley, Sanket S Dhruva
1University of California, Berkeley, School of Public Health, 5423 Berkeley Way West Hall, Berkeley, CA 94720-7360.
The American journal of managed care
|April 11, 2024
概括
医院门诊部门 (HOPD) 的结肠镜检查,关节镜检查和白内障手术费用明显高于门诊手术中心 (ASC). 通过并发症来衡量质量,HOPD和ASC之间是相似的,这表明成本更高而结果更好.
科学领域:
- 卫生经济学 卫生经济学
- 外科手术的结果
- 医疗保健政策 医疗保健政策
背景情况:
- 门诊手术越来越多地在医院门诊部 (HOPD) 和独立的门诊手术中心 (ASC) 进行.
- 了解这些护理环境之间的成本和质量差异对于医疗保健政策和患者决策至关重要.
研究的目的:
- 为了量化支付的价格和程序并发症的差异,在HOPDs和ASCs中进行的常见门诊手术.
- 为了比较不同外科设置的护理交付的成本效益.
主要方法:
- 一项观察性研究分析了蓝十字蓝盾公司 (2019-2020年) 的非识别国家保险索赔.
- 数据包括结肠镜,关节镜和白内障切除手术的价格和并发症.
- 多变量回归调整了患者和市场因素,以比较HOPD和ASC的结果.
主要成果:
- 在HOPD中,价格明显更高:结肠镜54.9%,关节镜44.4%,白内障手术44.0%.
- 关节镜检查和白内障切除的HOPD和ASC之间的并发症率相似.
- 在90天内进行结肠镜检查的HOPD患者中观察到略高的并发症率,但在7天或30天内没有出现并发症.
结论:
- 与ASC相比,这些门诊手术的HOPD价格较高与质量改善或并发症率降低无关.
- 这表明,通过将护理转移到ASC,可以节省成本,而不会影响这些程序的患者安全.
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