Predictors of the cost of hysterectomy for benign indications.
Predictors of the cost of hysterectomy for benign indications.
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良性适应症的子宫切除术成本的预测指标。
DOI：
10.1016/j.jogoh.2020.101936
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发表时间：
2021-03
影响因子：
1.9
通讯作者：
Borahay MA
中科院分区：
文献类型：
--
作者：
AlAshqar A;Goktepe ME;Kilic GS;Borahay MA
子宫切除术是一种常见的手术，其费用差异很大。随着妇科医生从侵入性方法转向微创方法，许多因素在决定子宫切除术的费用方面发挥着作用，应努力将其降至最低。我们的目标是确定子宫切除术费用的预测因素。这是一项回顾性队列研究，确定了 2009 年至 2016 年在德克萨斯大学医学分院因良性疾病接受子宫切除术的女性。我们从电子病历和医院财务部门获取并分析了人口统计、手术和财务数据。我们确定了 1,847 名女性。开腹子宫切除术是最常用的方法（35.8%），其次是阴道切除术（23.7%）、腹腔镜切除术（23.6%）和机器人切除术（16.9%）。多变量回归表明，子宫切除术费用可以根据手术方式、患者年龄、手术室 (OR) 时间、住院时间 (LOS)、估计失血量、保险类型、财政年度和伴随手术进行显着预测。 LOS 每增加一天，费用增加 3,723.57 美元（P <0.001），手术时间每增加一分钟，费用增加 76.02 美元（P <0.001），年龄每增加一年，费用增加 48.21 美元（P <0.037）。与阴道手术相比，调整 LOS 和 OR 时间分别显着降低了开放子宫切除术和机器人子宫切除术的成本。多种人口统计和手术因素可以预测子宫切除术的费用。包括妇科医生在内的医疗保健提供者需要在适当的资源管理中发挥额外作用，并熟悉治疗干预措施的成本驱动因素。未来的努力和政策应针对可修改的因素，以最大限度地降低成本并促进基于价值的实践。
Hysterectomy is a commonly performed procedure with widely variable costs. As gynecologists divert from invasive to minimally invasive approaches, many factors come into play in determining hysterectomy cost and efforts should be sought to minimize it. Our objective was to identify the predictors of hysterectomy cost. This was a retrospective cohort study where women who underwent hysterectomy for benign conditions at the University of Texas Medical Branch from 2009 to 2016 were identified. We obtained and analyzed demographic, operative, and financial data from electronic medical records and the hospital finance department. We identified 1,847 women. Open hysterectomy was the most frequently practiced (35.8%), followed by vaginal (23.7%), laparoscopic (23.6%), and robotic (16.9%) approaches. Multivariate regression demonstrated that hysterectomy charges can be significantly predicted from surgical approach, patient’s age, operating room (OR) time, length of stay (LOS), estimated blood loss, insurance type, fiscal year, and concomitant procedures. Charges increased by $3,723.57 for each day increase in LOS (P <0.001), by $76.02 for each minute increase in OR time (P <0.001), and by $48.21 for each one-year increase in age (P 0.037). Adjusting for LOS and OR time remarkably decreased the cost of open and robotic hysterectomy, respectively when compared with the vaginal approach. Multiple demographic and operative factors can predict the cost of hysterectomy. Healthcare providers, including gynecologists, are required to pursue additional roles in proper resource management and be acquainted with the cost drivers of therapeutic interventions. Future efforts and policies should target modifiable factors to minimize cost and promote value-based practices.
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影响因子：
2.3
作者：
van der Schans EM;Hiep MAJ;Consten ECJ;Broeders IAMJ
通讯作者：
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影响因子：
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作者：
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DOI：
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通讯作者：
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DOI：
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发表时间：
2014-03-01
影响因子：
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作者：
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