Imasogie Ngozi, Wong David T, Luk Ken, Chung Frances
Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.
Can J Anaesth. 2003 Mar;50(3):246-8. doi: 10.1007/BF03017792.
To evaluate the possible cost savings when routine preoperative testing is discontinued in ambulatory cataract surgery patients.
A policy was introduced at our hospital to stop routine testing in ambulatory cataract patients. Consecutive patients' medical records were analyzed in a four-month period pre- and a four-month period post-discontinuation of routine laboratory tests. Ambulatory cataract surgery is performed under topical (and sometimes retrobulbar block) anesthesia with iv sedation. Co-morbidities, perioperative events, frequency and cost of tests ordered were compared for the two groups. Average costs per patient pre- and post-discontinuation of routine tests, and total possible cost savings were calculated.
One thousand two hundred and thirty-one patients were studied; 636 had routine laboratory tests and 595 had no routine laboratory tests. The ratios of gender, co-morbidities and perioperative events were similar in the two groups. There was a significant reduction in the number of tests ordered after the new policy was introduced, from 5.8 tests per patient to 0.4 tests per patient. The cost of tests per patient was reduced from Can $39.67 to $4.01.
In ambulatory cataract surgery, over 90% savings in laboratory costs is possible after elimination of routine tests.
评估在门诊白内障手术患者中停止常规术前检查时可能节省的费用。
我院推行了一项政策，即停止对门诊白内障患者进行常规检查。对连续患者在停止常规实验室检查前的四个月和停止后的四个月期间的病历进行分析。门诊白内障手术在表面麻醉（有时加球后阻滞）和静脉镇静下进行。比较两组患者的合并症、围手术期事件、所开检查的频率和费用。计算停止常规检查前后每位患者的平均费用以及总的可能节省费用。
共研究了1231例患者；636例进行了常规实验室检查，595例未进行常规实验室检查。两组患者的性别、合并症及围手术期事件比例相似。新政策实施后，所开检查数量显著减少，从每位患者5.8项检查降至0.4项检查。每位患者的检查费用从39.67加元降至4.01加元。
在门诊白内障手术中，取消常规检查后实验室费用可节省90%以上。
