使用行政索赔数据库进行手术与非手术尾炎管理后的医疗保健利用率
Pawan J Mathew1, Miranda Moore, Bishwajit Bhattacharya
1From the Department of Surgery (P.J.M., M.M., B.B., E.S., K.D.), Yale School of Medicine, New Haven; and Department of Surgery (K.M.S.), Bridgeport Hospital, Yale School of Medicine, Bridgeport, Connecticut.
The journal of trauma and acute care surgery
|June 4, 2025
概括
与手术相比,尾炎的非手术治疗导致医疗保健的使用增加,包括紧急诊所和CT扫描. 非手术治疗的患者在一年内重复ED访问和住院的风险翻了一番.
科学领域:
- 一般外科 整体外科
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
背景情况:
- 不复杂的尾炎的非手术治疗越来越多地被采用.
- 复发性尾炎是非手术成功的一个关键指标.
- 本研究将尾切除术后的医疗保健利用率和成像暴露率与非手术管理进行比较.
研究的目的:
- 为了评估医疗保健利用率和医疗成像暴露在患者治疗非手术与手术治疗尾炎.
- 测试非手术管理导致医疗保健利用率在一年内增加的假设.
主要方法:
- 利用MarketScan索赔数据库 (2017-2021) 针对急性无并发性尾炎患者.
- 进行尾切除术的患者与非手术治疗的患者进行了比较.
- 分析了1年的医疗保健利用率:急救诊所,住院和腹部CT扫描用于腹部疼痛相关的诊断.
主要成果:
- 非手术治疗与更高的急救诊所,住院和CT扫描率有关.
- 非手术治疗的患者在1年内重复ED访问,住院或CT扫描的可能性大约是两倍.
- 一小部分 (3.1%) 的非手术治疗患者因复发性尾炎而进行尾切除.
结论:
- 无并发性尾炎的非手术治疗与医疗保健利用率的增加有关.
- 在非手术组中观察到更高的ED再访,住院和重复CT成像率.
- 这些发现凸显了手术和非手术方法在医疗保健资源使用中的权衡.
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