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保险状况与代谢/腹腔外科手术后术后资源利用的关联 - 一项多机构研究
Florina Corpodean1, Michael Kachmar1, Jake Doiron2
1Metamor Institute, Pennington Biomedical Research Center, Baton Rouge, Louisiana; Department of Surgery, Louisiana State University School of Medicine, New Orleans, Louisiana.
概括
接受减肥手术的公共保险患者在术后的急诊室访问和重新手术的次数更高. 需要有针对性的质量改进,以改善这些代谢和腹部外科手术患者的护理机会.
科学领域:
- 腹部外科 腹部外科
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 术后急诊室 (ED) 的使用和再接收是代谢和腹腔外科认证和质量改进计划 (MBSAQIP) 中心的关键质量指标.
- 由于医疗保健成本不断上升,减少术后资源利用是至关重要的.
研究的目的:
- 根据首要付款人身份,调查代谢和减肥手术 (MBS) 后术后资源利用的差异.
- 为了确定患者群体之间的结果差异,如再入院,再干预和再手术.
主要方法:
- 来自两个MBSAQIP认可中心的MBS病例的30天术后期的分析.
- 根据主要支付者的类型 (医疗补助,医疗保险,私人保险,自付) 分类患者.
- 按付款人身份分层分析再接纳,再干预和再操作.
主要成果:
- 医疗补助受益者比私人保险患者年轻,更有可能是女性,与私人保险患者相比,他们的体重指数更高.
- 医疗补助受益者使用ED的比例显著增加,手术时间更长.
- 尽管ED使用量增加和操作时间更长,但医疗补助状态与更高的复合并发症或再录取无关.
结论:
- 与私人保险或自付患者相比,公共保险患者 (医疗保险或医疗补助) 的术后ED使用率和再接收/再手术率更高.
- 这些发现强调了需要有针对性的质量改善举措,以加强接受MBS的公共保险人口获得护理的机会.
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