Hospital facilities and resource management: economic impact of a high-volume regional anesthesia program for outpatients.
Hospital facilities and resource management: economic impact of a high-volume regional anesthesia program for outpatients.
复制标题
医院设施和资源管理：门诊患者大量区域麻醉方案的经济影响。
DOI：
10.1097/01.aia.0000166188.53073.55
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发表时间：
2005
影响因子：
0.6
通讯作者：
Kentor,MichaelL
中科院分区：
文献类型：
--
作者：
Williams,BrianA;Motolenich,Peter;Kentor,MichaelL
不断寻求降低医疗费用导致更多的程序正在进行门诊的基础上。门诊整形外科手术后通常会出现急性疼痛和术后恶心和/或呕吐（PONV），当这些症状难以治愈时，和/或伴有高剂量全身麻醉剂、阿片类药物和镇静止吐药引起的嗜睡时，长时间的恢复室停留和计划外住院可能变得非常常见。门诊骨科手术的麻醉技术包括区域麻醉（RA）技术（特别是神经阻滞），并伴有（如有必要）丙泊酚为基础的全静脉麻醉，可以减少甚至消除术后疼痛、PONV、强制性第1阶段恢复室停留和计划外入院。此外，RA技术提供明确的手术麻醉，并在诱导室进行，可以显着减少手术室的麻醉控制时间。因此，使用RA的最积极的术后即刻结局为患者、家属、医院工作人员和管理人员提供了一个“双赢”的局面。本章具体回顾了1996年至1999年匹兹堡大学使用大量RA项目相关的资源管理和经济问题，特别关注手术室时间节省，恢复室使用减少和住院人数减少。我们还量化了麻醉后监护室（PACU）旁路和避免住院的组合所产生的医院成本节省。具体来说，我们的报告总结了我们对患者的工作
The constant quest to reduce healthcare costs has led to more procedures being performed on an outpatient basis. Outpatient orthopedic procedures are commonly followed by acute pain and postoperative nausea and/or vomiting (PONV), and when these symptoms are refractory, and/or are accompanied by somnolence resulting from high doses of general anesthetic agents, opioids, and sedating antiemetics, prolonged recovery room stays and unplanned hospital admissions can become very common. Anesthesia techniques for outpatient orthopedic surgery incorporating regional anesthesia (RA) techniques (especially nerve blocks), accompanied (if necessary) by propofol-based total intravenous anesthesia, can reduce or even eliminate postoperative pain, PONV, mandatory phase 1 recovery room stays, and unplanned admissions. In addition, RA techniques providing definitive surgical anesthesia and performed in an induction room can significantly reduce anesthesiacontrolled time in the operating room. Thus, the most positive immediate postoperative outcomes with the use of RA provide a ‘‘win–win’’situation for patients, families, hospital staff, and administrators. This chapter specifically reviews resource management and economic issues related to the use of a high-volume RA program at the University of Pittsburgh from 1996 through 1999, with a particular focus on operating room time savings, reductions in recovery room use, and reduction of hospital admissions. We also quantify the hospital cost savings generated by the combination of postanesthesia care unit (PACU) bypass and avoidance of hospital admissions. Specifically, our report summarizes our work with the patient