学术型医院与社区医院全关节置换术的疗效
Outcomes of total joint arthroplasty in academic versus community hospitals.
作者信息
Gandhi Rajiv, Tso Peggy, Davis Aileen, Mahomed Nizar N
机构信息
Division of Orthopedic Surgery, Toronto Western Hospital and University of Toronto, Toronto, Ont.
出版信息
Can J Surg. 2009 Oct;52(5):413-6.
BACKGROUND
Most joint-replacement surgeries are currently performed in community hospitals. We sought to determine whether the functional outcomes of joint-replacement surgery differ between academic and community hospitals.
METHODS
We surveyed 471 patients for demographic data, Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores and Medical Outcomes Study Short Form 36 (SF-36) scores at baseline and at 3-month and 1-year follow-up. We assessed patient satisfaction at 1 year with a single survey question.
RESULTS
Community hospital patients (n = 269) were significantly older and had greater comorbidity than academic hospital patients (n = 202; p < 0.05). We found no difference in WOMAC scores, SF-36 scores or in patient satisfaction between hospitals at 1-year follow-up (p > 0.05). Adjusted analysis showed that patients undergoing surgery in an academic or community hospitals have the same functional outcomes.
CONCLUSION
There is no significant difference in the functional outcomes of joint-replacement surgery between academic and community hospitals. Further work will involve evaluating cost of care differences between these types of hospitals.
背景
目前大多数关节置换手术在社区医院进行。我们试图确定学术医院和社区医院的关节置换手术功能结果是否存在差异。
方法
我们对471名患者进行了调查，收集其基线、3个月和1年随访时的人口统计学数据、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分以及医学结局研究简表36（SF - 36）评分。我们通过一个单一的调查问题评估患者1年时的满意度。
结果
社区医院患者（n = 269）比学术医院患者（n = 202）年龄显著更大且合并症更多（p < 0.05）。我们发现在1年随访时，各医院之间的WOMAC评分、SF - 36评分或患者满意度无差异（p > 0.05）。校正分析表明，在学术医院或社区医院接受手术的患者具有相同的功能结果。
结论
学术医院和社区医院的关节置换手术功能结果无显著差异。进一步的工作将涉及评估这些类型医院之间的护理成本差异。
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