Department of Surgery, University of North Dakota School of Medicine and Health Sciences, 501 North Columbia Road, Grand Forks, ND 58203, USA.
Am J Surg. 2009 Dec;198(6):829-33. doi: 10.1016/j.amjsurg.2009.04.031.
Recent literature suggests implantable central venous access ports (ICVAPs) can be placed by interventional radiologists with fewer complications and lower expenses when compared with surgeons. An analysis of outcomes and expenses of ICVAP placement by service was conducted.
Three hundred sixty-eight ICVAPs were placed over 3 years at a 230-bed community teaching hospital. A retrospective review of these procedures was conducted. Data recorded for each procedure included patient demographics, reason for placement, indwelling port days, complications, billed charges, and reimbursement.
Two hundred seventy-six (75%) ICVAPs were placed by interventional radiologists, while surgeons placed the remaining 92 ports (25%). Short-term complications were identified in 7 interventional radiologist-placed ports (2.5%) and 1 surgically placed port (1.1%), P = .42. Billed charges were greater for interventional radiologist-placed ports ($5,301 vs $4,552, P = .0001). In contrast, reimbursement was greater for surgically placed ports: interventional radiologist 31.3% of charges, surgery 42.8%, P = .049.
Reimbursement and charges demonstrated significant differences between surgeons and interventional radiologists. Prior assertions that ports placed by interventional radiologists are less expensive with fewer complications may no longer be valid.
最近的文献表明，与外科医生相比，介入放射学家可以通过更少的并发症和更低的费用来放置植入式中央静脉通路端口（ICVAP）。对服务方式的 ICVAP 放置结果和费用进行了分析。
在一家拥有 230 张病床的社区教学医院中，在三年内共进行了 368 例 ICVAP 放置。对这些手术进行了回顾性研究。为每个手术记录的数据包括患者人口统计学，放置原因，留置端口天数，并发症，计费费用和报销。
276 个（75％）ICVAP 由介入放射科医生放置，而其余 92 个端口（25％）由外科医生放置。在 7 个介入放射科医生放置的端口（2.5％）和 1 个外科医生放置的端口（1.1％）中发现了短期并发症，P =.42。介入放射科医生放置的端口的计费费用更高（$5,301 比 $4,552，P =.0001）。相比之下，外科医生放置的端口的报销更高：介入放射科医生为 31.3％的费用，手术为 42.8％，P =.049。
外科医生和介入放射科医生之间的报销和费用存在明显差异。先前的主张，即介入放射学家放置的端口并发症更少且费用更低，可能不再成立。
