医疗保险受益者在随后关闭的医院进行癌症手术后的结果
Min-Young Kim1, Douglas O Staiger1,2,3, Gabriel A Brooks1,4,5
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
JAMA network open
|January 13, 2026
概括
为结肠和肺癌手术而关闭的医院与增加的死亡率和并发症有关. 然而,大多数患者附近都有其他医院,这表明关闭可能会将患者转移到表现更好的设施,旅行影响最小.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 医院关闭引发了人们对医疗保健准入的担忧,特别是在癌症治疗等专门的手术护理方面.
- 医院关闭对癌症手术结果和患者旅行负担的影响在很大程度上仍未得到审查.
研究的目的:
- 调查在随后关闭的医院接受结肠或肺癌手术和患者结果之间的关联.
- 评估对Medicare受益人的术后并发症,死亡率和旅行距离的影响.
主要方法:
- 使用医疗保险行政数据 (2008-2019) 的回顾性队列研究.
- 确定了关闭的癌症外科医院,并分析了结果 (90天死亡率,并发症,停留时间) 和旅行措施.
- 使用后勤和线性回归来进行结果分析,并对旅行数据进行描述性分析.
主要成果:
- 在关闭的医院接受手术的患者更有可能有双重资格,属于少数种族群体,并有紧急入院.
- 关闭医院的手术与较高的结肠癌90天死亡率和更高的结肠癌和肺癌90天并发症有关.
- 大多数在最近的关闭医院接受治疗的患者在15分钟车程内有一个替代设施.
结论:
- 在随后关闭的医院接受癌症手术与术后结果更差有关.
- 医院关闭可能会通过将患者转移到表现更好的附近医院来改善癌症手术结果.
- 与医院关闭相关的增加的旅行负担对大多数患者来说似乎是最小的.
相关概念视频
01:21Cancer Survival Analysis
645
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
645
01:31Discharge Summary Forms
1.2K
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
1.2K
01:24Kaplan-Meier Approach
556
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
556