Roman Sanziana, Boudourakis Leon, Sosa Julie A
Section of Endocrine Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Curr Opin Oncol. 2008 Jan;20(1):47-51. doi: 10.1097/CCO.0b013e3282f46d4b.
We review recent health services research studies examining clinical and economic outcomes in endocrine surgery.
Recent studies have focused on such important issues as the use of the Internet in medicine, patient quality of life, cost-effectiveness of emerging surgical technologies, and labor-force modeling. There is a need for accurate and informative websites dedicated to thyroid disease, given the large number of patients who use the Internet for healthcare information. Debate continues about the relative merits of medical and surgical therapy for primary hyperparathyroidism; based on measurements of quality of life and cost-effectiveness, parathyroidectomy appears to be favored. Surgical outcomes studies have shown parathyroidectomy to be safe in octogenarian and nonagenarian patients with primary hyperparathyroidism. Sophisticated work-force projections suggest that the supply of endocrine surgeons will grow over the next 15 years, but will be outpaced by the anticipated demand.
Health services research is a burgeoning field of investigation in endocrine surgery. It needs to be developed to improve the quality of care of patients with thyroid, parathyroid, adrenal and endocrine pancreatic diseases.
我们回顾了近期关于内分泌外科临床和经济结局的卫生服务研究。
近期研究聚焦于医学中互联网的使用、患者生活质量、新兴手术技术的成本效益以及劳动力建模等重要问题。鉴于大量患者通过互联网获取医疗信息,需要有专门针对甲状腺疾病的准确且信息丰富的网站。关于原发性甲状旁腺功能亢进症内科和外科治疗的相对优点仍存在争议;基于生活质量和成本效益的衡量,甲状旁腺切除术似乎更受青睐。手术结局研究表明,甲状旁腺切除术对于患有原发性甲状旁腺功能亢进症的八九十岁患者是安全的。复杂的劳动力预测表明,未来15年内分泌外科医生的供应将会增加,但预计需求增长更快。
卫生服务研究是内分泌外科一个新兴的研究领域。需要进一步发展以提高甲状腺、甲状旁腺、肾上腺和内分泌胰腺疾病患者的护理质量。