在急性胆囊炎的非手术治疗中医院间的变化
Konmal Ali1, Nikhil L Chervu2, Sara Sakowitz1
1David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America.
PloS one
|June 10, 2024
概括
在急性胆囊炎的非手术治疗中存在医院变异性. 诸如老年和公共保险等因素影响非手术治疗,强调需要制定战略,确保提供公平的护理.
科学领域:
- 外科手术的结果
- 医疗服务研究 医疗服务研究
- 胃肠病学 胃肠病学
背景情况:
- 胆囊切除术是急性胆囊炎的标准治疗方法.
- 非操作性管理率正在增加.
- 假设手术率在医院一级存在显著的变化.
研究的目的:
- 描述在医院进行非手术治疗的患者,手术率正常和低.
- 确定与不同类型医院的非手术管理相关的因素.
主要方法:
- 利用了2016-2019年全国再录取数据库,用于成人急性胆囊炎的入院.
- 根据使用多层次混合效应建模的非操作率对中心进行排名.
- 在非手术率的上十分之一的医院被归类为低操作性医院 (LOH).
主要成果:
- 在418,545名患者中,9.9%的患者在880个LOH处得到治疗.
- 医院因素占非手术治疗变化的20.6%.
- 年龄较大,公共保险,安全网医院 (SNH) 状态和机构规模较小与非手术管理有关.
结论:
- 在急性胆囊炎的非手术治疗方面存在显著的医院间差异.
- 临床和社会经济因素同样影响LOH和非LOH的非操作性管理.
- 需要有针对性的战略来解决非临床差异,并确保公平的护理.
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