与冠状动脉旁路移植手术相关的术前和术后成本的决定因素
L R Smith1, C A Milano, B S Molter
1Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710.
Circulation
|November 1, 1994
概括
术前因素,如年龄较大,较低的射出分数,以及先前的冠状动脉旁路移植 (CABG) 手术,显著增加了医院费用. 了解这些预测因素有助于管理冠状动脉疾病治疗的成本.
科学领域:
- 心血管外科心血管外科
- 卫生经济学 卫生经济学
- 医疗信息学 医疗信息学
背景情况:
- 与程序相关的成本上升是选择冠状动脉疾病 (CAD) 治疗方法的一个主要考虑因素.
- 准确的成本评估对于有效的医疗管理和心血管外科手术的资源配置至关重要.
研究的目的:
- 确定术前患者特征,预测冠状动脉旁路移植 (CABG) 手术后的术后总医院费用.
- 为优化基于临床结果和经济影响的手术策略提供数据.
主要方法:
- 分析了1990年至1991年间接受CABG手术的604名患者的数据.
- 使用患者费用和医疗保险费用费用比率 (不包括专业费用) 来计算医院费用.
- 采用半参数回归模型来确定术后成本增加的重大风险因素.
主要成果:
- 术后医院费用中位数为12,912美元,但观察到有显著差异.
- 增加成本的关键预测因素包括年龄,左下心室喷射率,之前的CABG,女性性别,黑人种族和糖尿病.
- 缺乏先前的皮肤透光冠状动脉血管塑造和冠状动脉疾病的增加程度也与更高的成本相关.
结论:
- 手术前的患者因素对CABG手术具有重大经济影响.
- 外科医生和医疗保健提供者应该利用数据分析来比较管理策略,平衡死亡风险和成本效益.
- 有关患者选择和治疗途径的知情决策可以在CAD管理中更有效地利用资源.
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