门诊外科手术的使用变化
Chi Zhang1,2, Kristine Hanson2,3, Lindsey Sangaralingham2,3
1Department of Surgery, Mayo Clinic Arizona, Phoenix.
JAMA network open
|July 31, 2025
概括
地理位置显著影响美国各地的门诊手术率,医院地区是变化的主要驱动因素. 解决这些差异可以优化资源利用和改善外科手术护理的提供.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 改善外科手术的质量
- 卫生经济学 卫生经济学
背景情况:
- 在全国范围内,门诊手术率存在差异.
- 了解驱动这种变化的因素对于提高质量和优化资源至关重要.
研究的目的:
- 探索门诊外科手术利用的变化.
- 确定与这些变异相关的患者,地理和医院因素.
主要方法:
- 使用行政索赔数据 (OptumLabs数据仓库) 的回顾性横截面研究.
- 包括经过10次特定的一般性,泌尿学或妇科手术的成年患者 (2015-2021年).
- 多级逻辑回归以评估医院特征和人口普查划分的变化,调整患者因素.
主要成果:
- 在456,954名患者中,72.3%的患者进行了门诊手术.
- 在所有10项手术中,通过医院人口普查部门观察到门诊手术可能性的显著变化.
- 医院地理是10种手术中的8种门诊手术变化的主要贡献者.
- 较大的医院 (≥400张床位) 在几个手术中显示出门诊手术的几率下降.
- 住院计划影响了门诊手术的几率,在某些手术中增加,在其他手术中减少.
结论:
- 美国门诊手术率存在显著的地理差异,主要是由医院的位置驱动的.
- 这些发现突出了解决差异和提高手术护理提供效率的机会.
- 对区域实践模式的进一步研究可以为质量改进计划提供信息.
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