在三级医疗中心进行门诊大肠切除术的成本分析:预计的医疗经济评估
Fabio Agri1,2, William Möller1, Philip Deslarzes1
1Department of Visceral Surgery, Lausanne University Hospital CHUV, University of Lausanne (UNIL), Lausanne, Switzerland.
Health services insights
|September 30, 2024
概括
选择性门诊切除术为医疗保健系统提供了显著的成本节约. 然而,未来的支付系统可能会无意中惩罚高绩效的医院,阻碍这些高效战略的采用.
科学领域:
- 结肠直肠外科手术是什么意思
- 卫生经济学 卫生经济学
- 医疗保健管理的管理
背景情况:
- 短期停留过程旨在减轻对医疗保健系统的压力.
- 对于结肠切除,正在探索白天入院手术 (DAS) 和门诊策略.
- 未来的支付系统 (PPS) 影响医疗保健中的金融激励措施.
研究的目的:
- 在PPS框架内分析日入院手术 (DAS) 和结肠切除的门诊策略的财务影响.
- 将虚拟门诊和DAS策略的医疗经济结果与传统住院环境进行比较.
- 评估与虚拟门诊切除术策略相关的术后并发症.
主要方法:
- 虚拟门诊,DAS和传统的住院整形切除术的比较医疗经济评估.
- 包括连续接受左和右结肠切除的患者 (2019年1月 - 2020年12月).
- 直接医疗成本和成本收益分析的微成本计算方法.
主要成果:
- 在257例小肠切除术中,37.7%的人可能有资格接受门诊策略.
- 住院战略的成本覆盖率为98% (成本为3,634,392美元,收入为3,571,069美元).
- 虚拟DAS策略导致净损失为15,800美元 (覆盖率99%),而门诊病例显示覆盖率为108%.
结论:
- 从医院和医疗保健系统的角度来看,选择性门诊大肠切除术是从医院和医疗保健系统的角度来看,对被选中的患者来说最省钱的选择.
- 未来的支付系统可能会造成阻碍,使高绩效医院处于不利地位,并阻碍采取有价值的门诊策略.
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