Abdominal adhesiolysis: Inpatient care and expenditures in the United States in 1994
Abdominal adhesiolysis: Inpatient care and expenditures in the United States in 1994
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DOI：
10.1016/s1072-7515(97)00127-0
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发表时间：
1998-01-01
影响因子：
5.2
通讯作者：
Perry, S
中科院分区：
文献类型：
--
作者：
Ray, NF;Denton, WG;Perry, S
背景：粘连形成是下腹部手术后的主要并发症。据推测，近年来外科实践向使用微创技术（如腹腔镜）的转变可能与腹腔内粘连发生率和粘连松解术率的降低有关。使用归因风险方法，这项疾病成本研究旨在估计1994年美国粘连松解术的住院率和费用，并检查自1988年以来归因费用的变化。研究设计：使用全国出院数据库确定1994年美国进行的所有腹部粘连松解术。总住院费用基于粘连松解术住院和医生服务的医疗保险支付率，该支付率适用于粘连松解术的住院总天数。结果：1994年粘连松解术共住院303，836例，主要是消化道和女性生殖系统手术。这些程序占846,415天的住院治疗和13亿美元的住院和外科医生expenditures.Conclusions：虽然粘连松解术的住院率自1988年以来一直保持不变，住院费用下降了近10%，因为平均住院时间减少了15%。这6年期间腹腔镜使用的增加似乎与粘连松解术住院率的减少无关，这表明粘连形成的原因需要进一步研究。(C)1998年由美国外科医生学会。
Background: Adhesion formation represents a major complication after lower abdominal operations. It is postulated that a shift in surgical practice in recent years toward the use of less invasive techniques, such as laparoscopy, may be associated with a reduction in the incidence of intraperitoneal adhesions and in the rate of adhesiolysis procedures. Using an attributable-risk methodology, this cost-of-illness study was designed to estimate the hospitalization rate and expenditures for adhesiolysis in the United States in 1994 and to examine changes in attributable expenditures since 1988.Study Design: A national hospital discharge data base was used to identify all abdominal adhesion procedures performed in the United States in 1994. Total hospitalization expenditures were based on Medicare payment rates for adhesiolysis hospitalizations and physician services, which were applied to the total number of inpatient days attributed to adhesiolysis. The results were compared with published rates and expenditures attributed to adhesiolysis in 1988.Results: Adhesiolysis was responsible for 303,836 hospitalizations during 1994, primarily for procedures on the digestive and female reproductive systems. These procedures accounted for 846,415 days of inpatient care and $1.3 billion in hospitalization and surgeon expenditures.Conclusions: Although the adhesiolysis hospitalization rate has remained constant since 1988, inpatient expenditures have decreased by nearly 10% because of a 15% decrease in the average length of stay. The increased use of laparoscopy during this 6-year period does not appear to be associated with a concomitant reduction in the adhesiolysis hospitalization rate, suggesting that the causes of adhesion formation warrant further research. (C) 1998 by the American College of Surgeons.