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[基层医疗中引入小型手术项目的经济影响]

[Economic impact of the introduction of a minor surgery program in primary care].

作者信息

Tárraga López P J, Marín Nieto E, García Olmo D, Celada Rodríguez A, Solera Albero J

机构信息

Coordinator Médico EAP Casas Ibáñez. Albacete.

出版信息

Aten Primaria. 2001 Mar 31;27(5):335-8. doi: 10.1016/s0212-6567(01)79377-8.

Abstract

OBJECTIVE

To value the economic impact of implantation (establishment) of a minor surgery programme within health area of primary care in Albacete (Spain).

SETTING

Primary care (PC).

DESIGN

Observational, cross-sectional and retrospective study. Interventions and measurements. It has been recorded some patients operated on subsidiary minor surgery pathologies in the three health centers of Albacete area that participated in pilot experience from 1 November 1997 to 30 October 1998. It has been calculated the fixed costs corresponding to sanitary staff and the repayment of chirurgical area daily. As well, it were calculated the costs corresponding to disposable and not disposable equipment. It were analysed costs in function of intervention and the total cost were compared with the cost it would have supposed if it would carried out in specialized private centers according to up to dated fees of 1998 insurance companies.

MAIN RESULTS

During the study interval were operated on 185 patients with an average age of 64,5 years (SD +/- 21,4) with a slight predominance of women. All pathologies treated were benign, 39 cases were abscess, 38 were nail pathology, and 35 were foreign bodies removed.Cost were calculated on the basis of time of one year. Total cost of minor surgery programme were 1.234.440 Pts (7715 Euros) whereas if it would have carried out at specialized level it supposed between 2621450 Pts (15755.23 Euros) and 4440000 Pts (26684.94 Euros).

CONCLUSION

In our study, the minor surgery programme in primary care diminish the cost in comparison with private specialized level, at the same time as reducing standby list in specialities like surgery or dermatology.

摘要

目的

评估在西班牙阿尔瓦塞特初级保健卫生区域内实施小型外科手术项目的经济影响。

背景

初级保健(PC)。

设计

观察性、横断面和回顾性研究。干预措施与测量。记录了1997年11月1日至1998年10月31日期间在阿尔瓦塞特地区参与试点经验的三个卫生中心接受辅助小型外科手术治疗的部分患者。计算了与卫生工作人员相对应的固定成本以及手术区域的每日费用偿还。此外,还计算了一次性和非一次性设备的成本。分析了干预措施的成本,并将总成本与按照1998年保险公司最新收费标准在专门的私立中心进行手术的成本进行了比较。

主要结果

在研究期间,对185名患者进行了手术,平均年龄为64.5岁(标准差±21.4),女性略占多数。所有治疗的病症均为良性,39例为脓肿,38例为指甲病症,35例为取出异物。成本按一年时间计算。小型外科手术项目的总成本为1,234,440比塞塔(7715欧元),而如果在专科水平进行手术,成本预计在2,621,450比塞塔(15,755.23欧元)至4,440,000比塞塔(26,684.94欧元)之间。

结论

在我们的研究中,与私立专科水平相比,初级保健中的小型外科手术项目降低了成本,同时减少了外科或皮肤科等专科的候诊名单。

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