Data resources for evaluating the economic and financial consequences of surgical care in the United States.
Data resources for evaluating the economic and financial consequences of surgical care in the United States.
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用于评估美国外科护理的经济和财务后果的数据资源。
DOI：
10.1097/ta.0000000000003631
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
AA
中科院分区：
文献类型：
--
作者：
Scott,JohnW;Ayoung-Chee,Patricia;Lester,EricaLW;Bruns,BrandonR;Davis,KimberlyA;Gore,Amy;Knowlton,LisaMarie;Liu,Charles;Martin,RShayn;Oh,EstherJiin;Ross,SamuelWade;Wandling,Michael;Minei,JosephP;Staudenmayer,Kristan;AA
在当前的医疗保健经济环境下，评估医疗保健成本与质量之间的关系至关重要，因为需要了解价值来推动政策决策。虽然许多政策分析都集中在更大的医疗保健系统上，但迫切需要进行外科手术式的经济分析。手术治疗费用昂贵，手术室不断引入创新技术，手术治疗影响患者的短期和长期身体和经济福祉。不幸的是，关于手术干预的成本、价值和经济影响之间的关系，存在重大的知识差距。尽管以索赔数据库、出院数据库和全国调查的形式提供了大量的医疗保健数据，但没有一个单一的数据源包含每项与政策相关的外科护理分析所需的所有信息。因此，了解哪些数据可用以及每个数据集可以完成什么工作非常重要。在本文中，我们概述了外科医疗服务研究中常用的数据库。我们重点审查以下五类数据：政府索赔数据库、商业索赔数据库、医院临床数据库、州和国家出院数据库以及国家调查。对于每一个，我们都总结了数据库抽样框架、临床相关变量、与经济分析相关的变量、优点、缺点以及手术相关分析的示例。本综述旨在增进对当前可用数据状况的理解，并激发对手术人群的新颖分析。关于国家卫生政策改革的持续辩论可能会影响未来几十年外科护理的提供。适当使用现有数据资源可以提高我们对手术护理对医疗保健系统和患者的经济影响的理解。（J Trauma Acute Care Surg. 2022；93：e17–e29。版权所有© 2022 Wolters Kluwer Health, Inc. 保留所有权利。）证据级别：定期审查，V 级。
Evaluating the relationship between health care costs and quality is paramount in the current health care economic climate, as an understanding of value is needed to drive policy decisions. While many policy analyses are focused on the larger health care system, there is a pressing need for surgically focused economic analyses. Surgical care is costly, and innovative technology is constantly introduced into the operating room, and surgical care impacts patients' short-and long-term physical and economic well-being. Unfortunately, significant knowledge gaps exist regarding the relationship between cost, value, and economic impact of surgical interventions. Despite the plethora of health care data available in the forms of claims databases, discharge databases, and national surveys, no single source of data contains all the information needed for every policy-relevant analysis of surgical care. For this reason, it is important to understand which data are available and what can be accomplished with each of the data sets. In this article, we provide an overview of databases commonly used in surgical health services research. We focus our review on the following five categories of data: governmental claims databases, commercial claims databases, hospital-based clinical databases, state and national discharge databases, and national surveys. For each, we present a summary of the database sampling frame, clinically relevant variables, variables relevant to economic analyses, strengths, weaknesses, and examples of surgically relevant analyses. This review is intended to improve understanding of the current landscape of data available, as well as stimulate novel analyses among surgical populations. Ongoing debates over national health policy reforms may shape the delivery of surgical care for decades to come. Appropriate use of available data resources can improve our understanding of the economic impact of surgical care on our health care system and our patients.(J Trauma Acute Care Surg. 2022; 93: e17–e29. Copyright© 2022 Wolters Kluwer Health, Inc. All rights reserved.)LEVEL OF EVIDENCE: Regular Review, Level V.