A financial analysis of operating room charges for robot-assisted gynaecologic surgery: Efficiency strategies in the operating room for reducing the costs
A financial analysis of operating room charges for robot-assisted gynaecologic surgery: Efficiency strategies in the operating room for reducing the costs
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DOI：
10.5152/jtgga.jtgga.2014.79989
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发表时间：
2014-03-01
影响因子：
1.4
通讯作者：
Kilic, Gokhan Sami
中科院分区：
文献类型：
--
作者：
Zeybek, Burak;Oge, Tufan;Kilic, Gokhan Sami
目的：分析机器人辅助妇科手术控制台时间开始之前手术室 (OR) 中发生的步骤，并确定减少手术室非手术时间的潜在方法。 材料和方法：对德克萨斯大学医学分部 (UTMB) 妇产科连续 13 例机器人治疗良性妇科疾病病例进行回顾性分析。收集的数据包括具体术语“麻醉完成”（步骤 1）、“铺巾完成”（步骤 2）和“套管针插入”（步骤 3），所有这些都是指实际手术开始前的时间，开腹/阴道子宫切除术、腹腔镜子宫切除术和机器人辅助子宫切除术的 OR 费用分别评估为 3、4 和 5 级。 结果： 3、4 和 5 级手术中 0-30 分钟和每增加 30 分钟的 OR 分别为 3,693 美元和 1,488 美元、4,961 美元和 2,426 美元、5,513 美元和 2,756 美元。步骤 1 的中位时间为 12.1 分钟 (5.25-23.3)，步骤 2 的中位时间为 19 (4.59-44) 分钟，步骤 3 的中位时间为 25.3 (16.45-45) 分钟。到实际手术开始为止的总中位时间为 54.58 分钟 (40-100)。按级别 4 计算费用时的总成本为 6948.7 美元，按级别 5 计算费用时的总成本为 7771.1 美元。结论：由于收费水平，机器人辅助手术在麻醉诱导和患者铺巾的手术准备阶段已经“成本昂贵”。应尽一切努力缩短时间并减少使用的器械数量，同时不影响护理。
Objective: To analyse the steps taking place in the operating room (OR) before the console time starts in robot-assisted gynaecologic surgery and to identify potential ways to decrease non-operative time in the OR.Material and Methods: Thirteen consecutive robotic cases for benign gynaecologic disease at the Department of Obstetrics and Gynecology at University of Texas Medical Branch (UTMB) were retrospectively reviewed. The collected data included the specific terms 'Anaesthesia Done' (step 1), 'Drape Done' (step 2), and 'Trocar In' (step 3), all of which refer to the time before the actual surgery began and OR charges were evaluated as level 3, 4, and 5 for open abdominal/vaginal hysterectomy, laparoscopic hysterectomy, and robot-assisted hysterectomy, respectively.Results: The cost of the OR for 0-30 minutes and each additional 30 minutes were $3,693 and $1,488, $4,961 and $2,426, $5,513 and $2,756 in level 3, 4, and 5 surgeries, respectively. The median time for step 1 was 12.1 min (5.25-23.3), for step 2 was 19 (4.59-44) min, and for step 3 was 25.3 (16.45-45) min. The total median time until the actual operation began was 54.58 min (40-100). The total cost was $6948.7 when the charge was calculated according to level 4 and $7771.1 when the charge was calculated according to level 5.Conclusion: Robot-assisted surgery is already 'cost-expensive' in the preparation stage of a surgical procedure during anaesthesia induction and draping of the patient because of charging levels. Every effort should be made to shorten the time and reduce the number of instruments used without compromising care.