我们终于可以量化腰部融合的价值吗? 引入运营价值指数 (OVI)
Advith Sarikonda1, Ashmal Sami1, Adam Leibold1
1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience.
Clinical spine surgery
|January 15, 2026
概括
这项研究引入了新的指标,将患者的结果和成本结合起来,以衡量转腰部体融合 (TLIFs) 的价值. 一些外科医生表现出更高的价值,突出了脊柱手术效率的差异.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 卫生经济学 卫生经济学
- 基于价值的护理是基于价值的护理.
背景情况:
- 患者报告的结果 (PRO) 和成本分析在脊柱手术研究中至关重要.
- 很少有研究将PRO与基于时间驱动的活动成本 (TDABC) 整合在一起,以评估外科价值.
- 量化外科价值对于提高医疗保健效率和患者治疗结果至关重要.
研究的目的:
- 将患者报告的结果 (PROs) 与基于时间驱动的活动成本 (TDABC) 整合起来,以量化单一水平的变形椎椎体间融合 (TLIF) 的价值.
- 在外科医生层面和程序层面评估价值.
- 为了识别不同外科医生之间手术价值的差异.
主要方法:
- 由神经外科医生进行的142个单级TLIF的回顾性分析.
- 操作内基于时间的基于活动的成本计算 (TDABC) 来确定直接和间接成本.
- 奥斯韦斯特里残疾指数 (ODI) 在手术前和手术后收集;运行价值指数 (OVI) 和结果单位价格 (UPO) 计算.
- 一般化的线性混合模型 (GLMM) 用于分析外科医生水平的OVI变异性.
主要成果:
- 一级TLIF的平均成本为11,984美元.
- 平均操作价值指数 (OVI) 为3.2,结果单位价格 (UPO) 为643.3美元.
- 被归类为"其他外科医生"的外科医生与外科医生A相比显示明显较低的OVI (P<0.05),表明较低的值.
结论:
- 结合诊断特定的PRO和TDABC的新型指标有效量化单一水平TLIF的价值.
- 这些指标可以帮助利益相关者识别导致脊椎外科医生价值差异的因素.
- 这些发现强调了在外科实践中评估临床结果和成本效益的重要性.
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