消化管切除术趋势和私募股权获得的健康中心的术后结果
Jonathan E Williams1,2, Sara L Schaefer1,2, Ryan C Jacobs2,3
1Department of Surgery, University of Michigan, Ann Arbor.
JAMA surgery
|January 2, 2025
概括
与未获得中心的患者相比,在私募股权获得的医院接受食道切除术的患者面临30天死亡率,并发症和救助失败的风险更高. 需要进一步的研究来了解手术结果中的这些差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 医疗保健管理的管理
背景情况:
- 美国急症医院的私募股权 (PE) 收购正在增加.
- 获得PE医院的护理质量越来越令人担忧.
- 复杂的手术的结果,如PE获得的医院的食道切除术在PE获得的医院仍然没有研究.
研究的目的:
- 为了比较PE获得和非获得的健康中心之间的食道切除术的结构特征和术后结果.
- 确定与医院所有权相关的护理质量的潜在差异.
主要方法:
- 对接受选择性食道切除术 (2016-2020) 的医疗保险受益者 (65至99岁) 的回顾性队列研究.
- 医疗中心被归类为使用医疗保健研究和质量汇编机构获得的PE.
- 分析了30天的术后并发症,死亡率,救援失败和再入院情况.
主要成果:
- 总共有9,462名患者被纳入;5.5%在PE获得的医院接受护理.
- 获得PE医院的医院每年手术量较低.
- 患有PE的医院患者的30天死亡率更高 (8.1%与4.9%相比),并发症 (36.6%与30.1%相比),严重并发症 (17.5%与14.3%相比) 和救援失败 (5.9%与3.4%相比).
结论:
- 在患有PE的医院进行食管切除术与术后结果明显恶化有关.
- 患者可能面临死亡和并发症的风险增加.
- 进一步调查这些结果的驱动因素对于改善护理和告知政策至关重要.
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