在美国创伤患者多重肋骨骨折的肋骨固定的成本效益分析
Nancy Y Orduño Villa1, Himani Bhatt, Jennifer Hernandez
1From the Memorial Healthcare System, General Surgery Residency (N.Y.O.V., H.B., J.H., L.N., J.C., S.R., A.R.); University of South Florida, Division of Trauma Critical Care Surgery (G.C.); and Division of Trauma Critical Care Surgery (J.P.P.), Memorial Regional Hospital, Charles E. Schmidt College of Medicine, Florida Atlantic University, Hollywood, Florida.
肋骨骨折的手术稳定增加了初始住院费用,但减少了再入院. 这种方法可能为多重肋骨骨折的创伤患者提供长期的节省和改善结果.
科学领域:
- 创伤外科 手术 创伤外科
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 肋骨骨折的手术稳定越来越多地用于除胸部骨折之外的指示.
- 关于这种扩展外科手术方法的成本效益的数据有限.
- 这项研究评估了接受肋骨修复的美国创伤患者的住院费用和结果.
研究的目的:
- 为了比较多重肋骨骨折的创伤患者之间的住院费用和结果,这些患者接受了手术固定与非手术管理.
- 分析肋骨固定对再接收率,医疗保健总费用,保险状况,收入和医院类型的影响.
主要方法:
- 利用全国再接收数据库 (2016-2020年) 对多重肋骨骨折的创伤患者.
- 雇员倾向性得分匹配 (1:1) 以根据受伤严重程度,并发症和人口统计数据将肋骨固定患者与非手术对照进行比较.
- 主要结局:1年的医院再入院. 二次结果:总成本,保险,收入和医院的所有权.
主要成果:
- 肋骨固定与重新入院的风险降低有关 (OR 0.76; p < 0.01).
- 医院住院费用指数在肋骨固定方面高出44.1% (59,317美元与41,165美元).
- 包括再入院在内的总费用在肋骨固定方面高出37.7% (61,438美元与44,612美元相比).
- 私人保险患者更有可能接受固定治疗;低收入和公共医院患者的可能性较低.
结论:
- 肋骨骨折的手术稳定增加了预付费用,但可以通过减少再入院减少整体费用.
- 调查结果支持扩大肋骨固定的使用,同时揭示了接入差异.
- 需要进一步的研究,以解决公平获得肋骨骨折手术稳定性的问题.
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