预测同日乳房切除术后一夜间入院的因素 协议和相关的财务影响
Nicholas Caminiti1, Aye Aye Maung2, Jeremy Gaskins2
1From the Department of Surgery, University of Louisville School of Medicine, Louisville, KY (Caminiti, Jacobs, Spry, Scoggins, Wilhelmi, McMasters, Ajkay).
Journal of the American College of Surgeons
|July 30, 2024
概括
同一天乳房切除术 (SDM) 是安全的,但诸如手术前阿片类药物使用和后期手术开始时间等因素可以预测一夜间入院 (OAM). 虽然OAM增加了成本,但它并没有降低医院的利.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 卫生经济学 卫生经济学
背景情况:
- 同一天乳房切除术 (SDM) 协议越来越多地被采用,与疫情前水平相比,使用量增加了4倍.
- 尽管证明了安全性,但影响乳腺切除术 (OAM) 后一夜住院和相关护理费用的因素需要确定.
研究的目的:
- 为了确定计划在同一天进行乳房切除术后一夜间入院的预测因素.
- 评估一夜间入院与当天出院的经济影响.
主要方法:
- 在2020年3月至2022年4月期间,对183名接受乳腺切除术的患者进行了回顾性分析.
- 在SDM和OAM组之间比较人口,瘤,手术和术后因素,30天并发症,成本和贡献率.
主要成果:
- 43%计划接受SDM的患者需要OAM.
- 手术前使用阿片类药物,美国麻醉学会更高的类别,以及后来的手术开始时间预测了OAM.
- 经营管理成本与较高的固定和可变成本有关,但贡献率在各组之间相似.
结论:
- 手术前使用阿片类药物,ASA类,长时间停留PACU,下午手术开始时间是计划SDM后OAM的独立预测因素.
- 住院住院增加医疗费用,但不会对医院的利能力产生负面影响.
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