退伍军人冠状动脉旁路移植的成本:退伍军人健康管理局与社区护理
Jake L Cotton1, Adnan Syed2, Danielle Abbitt3
1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado; Department of Surgery, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, Colorado; Denver Seattle Center of Innovation, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, Colorado.
The Journal of surgical research
|October 2, 2025
概括
冠状动脉旁路移植 (CABG) 手术成本最初在退伍军人卫生管理局 (VHA) 和社区医院之间相似. 然而,在调整住宿时间等因素后,VHA CABG程序被发现成本更低,突出了有效的护理交付.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心血管外科心血管外科
- 卫生经济学 卫生经济学
背景情况:
- 退伍军人健康管理局 (VHA) 社区护理计划为社区环境中的退伍军人医疗提供资金.
- 社区护理成本不断上升,需要与VHA护理进行成本比较.
- 对于VHA和社区医院之间的冠状动脉旁路移植 (CABG) 等手术,存在有限的比较成本数据.
研究的目的:
- 为了比较VHA与社区护理医院内进行的冠状动脉旁路移植 (CABG) 手术的成本.
- 为了确定VHA资助的心脏手术的潜在成本效益.
主要方法:
- 在2018年10月至2020年9月期间接受CABG的退伍军人的回顾性队列研究.
- 从VHA和退伍军人综合服务网络19中的社区护理医院收集的数据.
- 用VHA数据库分析了医院住院费用指数.
主要成果:
- 361名退伍军人接受了CABG,其中54%在VHA和46%在社区医院.
- 最初的中位成本相似:VHA$122,213与社区$112,923 (P=0.23),尽管VHA术后停留时间较长.
- 在控制住宿时间等因素后,VHA CABG的成本显著降低 (P=0.007).
- 在医院住院指数指标或30天结果中没有观察到差异.
结论:
- 在考虑相关因素时,冠状动脉旁路移植 (CABG) 在VHA内比社区护理更便宜.
- 持续评估社区护理成本对于VHA资金效率和计划可持续性至关重要.
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