胃肠癌手术后成本中心的变化
Eshetu B Worku1, Mujtaba Khalil1, Selamawit Woldesenbet1
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Annals of surgical oncology
|November 19, 2024
概括
在复杂的胃肠道手术中,患者因素决定了大部分成本变化,而不是医院或外科医生的选择. 标准化护理协议可以提高质量和成本效益.
科学领域:
- 卫生经济学 卫生经济学
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尽管有标准化努力,但保险索赔存在显著的成本差异.
- 确定影响医院和成本中心变化的因素对于复杂的胃肠道手术至关重要.
研究的目的:
- 在复杂的胃肠道外科手术后,确定和量化导致医院和成本中心水平成本变化的因素.
- 分析患者,外科医生和医院因素对整体手术成本的影响.
主要方法:
- 利用监测,流行病学和最终结果数据库来识别接受胰腺切除术,胆管切除术或肉管切除术的患者.
- 在1,262家医院中比较指数手术费用,调整了临床,人口和地理变量.
- 采用多级回归建模来确定与电荷变化相关的因素.
主要成果:
- 手术室,住院和专业费用是最高的成本中心,占总费用的60%.
- 患者因素解释了总费用变化的最大比例 (83%),其次是外科医生 (9%) 和医院 (8%) 的因素.
- 医疗保险支付的中位数因癌症类型而异,胰腺切除术是最昂贵的.
结论:
- 在胃肠道癌症手术的成本中心层面,支出存在明显的差异.
- 与患者相关的因素是成本变化的主要驱动因素,超过了医院和外科医生的影响.
- 实施基于价值的医疗保健和标准化的协议可以提高医疗保健质量和成本效益.
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