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在为乳腺癌进行立即乳腺重建后,无计划的180天再接收和医疗保健利用

Arturo J Rios-Diaz¹, Theodore E Habarth-Morales^1,2, Emily L Isch³

¹Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

Journal of reconstructive microsurgery

|November 4, 2024

概括

经过立即的乳房重建后,大多数重入医院的病例发生在30天后,通常是由于感染. 解决这些出院后的并发症是减少医疗保健利用率和成本的关键.

科学领域:

在瘤学瘤学.
整形外科整形外科整形外科
医疗保健服务研究医疗服务研究

背景情况:

评估出院后30天以后的医疗保健使用情况,以立即进行乳房重建 (IBR).
了解乳腺切除术和IBR后再接收的国家负担.

研究的目的:

评估IBR后180天计划外再接收的程度和相关因素.
确定与这些再入院相关的附加医院费用.

主要方法:

对接受乳腺切除和IBR的妇女的2010-2019年全国再接收数据库的分析.
使用了考克斯的比例危险和通用线性回归模型.
对患者和医院级混因素进行控制,以确定再接收预测因素和成本驱动因素.

主要成果:

在100,942名妇女中,有10.7%的妇女在IBR后180天内再次入院.
在IBR类型 (组织扩展器,植入物,自身) 中,再接收率没有显著差异.
感染是主要原因 (29.8%);再接收与公共保险,低社会经济地位和更高的并发症负担有关.
再入院额外增加了8,971.78美元的医院费用,占IBR总费用的15%.

结论:

大多数从IBR后再入院的医疗保健利用超出了30天.
有证据表明,医疗保健是分散的,其中21.7%的再入院发生在不同医院.
减少术后传染性并发症是减少再入院的最大潜力.

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