医院住院费用与中心相关的变化对于接受皮肤穿刺左心室尾闭塞的患者
Shivaraj Patil1, Chaitanya Rojulpote2, Abhijit Bhattaru3
1Division of Cardiology, Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Structural heart : the journal of the Heart Team
|February 28, 2025
概括
对于Watchman设备植入的医院费用因中心而异,而不是患者因素. 高体积的中心减少了成本和变化,强调需要解决基于价值的护理的中心特定成本差异.
科学领域:
- 心血管干预 心血管干预
- 卫生经济学 卫生经济学
- 医疗器械技术 医疗器械技术
背景情况:
- 使用Watchman装置进行穿皮左心房尾闭塞在美国越来越多地使用.
- 了解成本变化对于优化医疗保健资源配置至关重要.
研究的目的:
- 为了评估Watchman设备植入的总医院费用的中心特定变化.
- 在全国范围内确定导致高住院费用的因素.
主要方法:
- 分析2016-2018年全国住院患者数据库,用于接受选择性观察员手术的成年患者.
- 利用混合效应模型来评估中心对成本的影响,根据患者和中心的特点和停留时间进行调整.
主要成果:
- 总共有30,175名患者进行了Watchman植入,平均费用为24,500美元,显示出大量的入院间变化.
- 大约13%的成本变化与执行中心有关,而不是患者特定的因素.
- 较高体积的中心表现出更低的成本和更少的成本变化. 低的手术量,并发症,充血性心力衰竭和更长的停留时间预计会导致更高的成本.
结论:
- 中心执行的手术对Watchman植入的总医院费用的变化有显著的贡献.
- 解决与中心相关的成本变化对于在Watchman程序中实现高质量,以价值为基础的护理至关重要.
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