腹股沟疝日间手术与住院手术方式的健康经济评价比较

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-01-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.01.015

Xin Jin, Yi Wang, Junhong Liu, Yifan Sun, Yu Wang, Ziyang Hang, Qiang Yu, Yi Wei

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引用次数: 0

摘要

目的采用健康经济的方法评价儿童日间手术模式和住院住院手术模式，为儿童腹股沟斜疝手术的优化和决策提供参考。方法收集2016年6月至2017年7月389例不间断单侧腹股沟斜疝患儿的临床资料。两种模式分别为日间手术(日间组，n=324)和住院住院手术(特殊组，n=65)。比较两组患者一般资料、治疗指标、容错、术后并发症发生率、复发率、医院感染等方面的差异。比较医院消费者对医疗服务提供者和系统调查满意度、住院时间、住院费用等卫生经济指标的组间差异。统计分析两种模式的成本-效果，包括治疗效果权重W、治疗效果指数EI和成本-效果比CER。结果组间性别、地区差异无统计学意义。而特殊群体的年龄分布更广。普通组和住院组的平均病床占用时间分别为(23.17±0.49)小时和(112.06±19.75)小时，差异有统计学意义(P<0.01)。普通组住院费用为(3372±430)元，特殊组住院费用为(6063±2104)元，差异有统计学意义(P<0.01)。麻醉级ASA比例组间差异有统计学意义。并发症发生率组间差异无统计学意义。日间组和住院组的治疗效果指数分别为0.98和1.02，成本-效果比分别为3305和6184。因此，白日组的经济效益更大。结论日间手术模式的成本-效果比优于住院手术模式。两组患者满意度及术后复发率无明显差异。日间手术模式可以推荐给有日间手术指征的儿童。关键词:儿童;一天手术;腹股沟疝;斜疝;卫生经济学评价

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Comparison of health economical evaluation between day surgery and inpatient hospitalization surgery mode for inguinal hernia

Objective To evaluate the day surgery mode of children and inpatient hospitalization surgery mode by using health economical methods and provide reference for optimization and decision of children indirect inguinal hernia operated. Methods Clinical data were collected from 389 children of uninterrupted unilateral indirect inguinal hernia from June 2016 to July 2017. Two modes were day surgery (day group, n=324) and inpatient hospitalization surgery (special group, n=65). The inter-group differences in general patient data, treatment index, fault tolerance, incidence of postoperative complications, recurrence rate and hospital infection were compared. And the inter-group differences in Hospital Consumer Assessment of Healthcare Providers and Systems Survey satisfaction, hospitalization stay, hospitalization cost and other health economic indicators were compared. The cost-effect of two modes was analyzed statistically, including weight of therapeutic effect W, treatment effect index of EI and cost-effect ratio CER. Results No inter-group statistical difference existed in gender or region. However, age distribution was wider in special group. The average bed occupancy time in day and inpatient groups was (23.17±0.49) and (112.06±19.75) hours respectively and the differences was statistically significant (P<0.01). And the hospitalization expenditure was (3372±430) and (6063±2104) yuan in day and special groups and the differences was statistically significant (P<0.01). The inter-group differences were statistically significant in the proportion of anesthetic grade ASA . And the incidence of complications showed no significant inter-group differences. In day and inpatient groups, the treatment effect index was 0.98 and 1.02 and the cost-effect ratio 3305 and 6184 respectively. Thus the economic benefits were greater in day group. Conclusions The cost-effect ratio of day surgery mode is superior to that of inpatient hospitalization surgery mode. No obvious differences exist in patient satisfaction or postoperative recurrence rate. Day surgery mode may be recommended for children with the indications of day surgery. Key words: Child; Day surgery; Inguinal hernia; Indirect hernia; Health economics evaluation

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.