泌尿病在退伍军人事务医疗保健系统中的住院自主权
Anh Thuy Nguyen1, Joseph B Oliver2, Kunj Jain1
1Division of Urology, Rutgers New Jersey Medical School, Newark, New Jersey.
Journal of surgical education
|December 18, 2024
概括
在VA系统中,外科住院医生的泌尿病学自主性下降了. 作为主要住院病例的病例显著下降,在手术时间或并发症方面没有差异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科教育的外科教育
- 医疗保健政策 医疗保健政策
背景情况:
- 由于诸如值班时间限制和监督等因素,外科住院医生的自主性正在下降.
- 了解住院外科独立性的趋势对于有效的培训至关重要.
研究的目的:
- 检查退伍军人事务 (VA) 医疗保健系统内的泌尿器科住院外科自治的趋势.
- 确定导致居民自主权变化的因素.
主要方法:
- 在2004年至2019年期间,使用VA外科手术质量改善计划 (VASQIP) 分析了93756例泌尿病例.
- 根据居民参与情况对病例进行分层:主治医院 (AP),主治医院和住院 (AR),主治医院 (RP).
- 专注于常见的手术:TURP,TURBT,前列腺蒸发,阴囊手术,尿路支架放置.
主要成果:
- 主要居民 (RP) 病例的百分比从2004年的44.4%下降到2019年的25.1%.
- 在所有检查的泌尿器科手术中都观察到这种下降.
- 涉及住院病例的患者有较高的医学并发症,但手术时间和术后结果没有显著差异.
结论:
- 在过去的15年里,在VA系统内,泌尿外科住院医生的外科自主性下降了.
- 当居民担任首席外科医生时,居民参与并没有导致明显不同的手术时间或术后并发症.
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