Elixhauser Anne, Andrews Roxanne M
Center for Delivery, Organization, and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland 20850, USA.
Arch Surg. 2010 Dec;145(12):1201-8. doi: 10.1001/archsurg.2010.269.
To provide an overview of inpatient operating room (OR) procedures in the United States.
DESIGN, SETTING, AND PATIENTS: Healthcare Cost and Utilization Project 2007 Nationwide Inpatient Sample discharge data from a sample of US short-term, acute-care, nonfederal hospitals.
National volume of OR procedures overall and by type of procedure, resource use and costs, most frequent and expensive procedures, and trends.
Fifteen million OR procedures were performed in 2007 (495 procedures/10 000 population). Only 26.4% of hospitalizations involved an OR procedure; however, OR-related stays were responsible for 46.8% of hospital costs ($161 billion). Patients aged 65 years and older were 2 to 3 times more likely to experience OR procedures (eg, 1327 procedures/10 000 persons among those aged 65-84 years vs 626 procedures/10 000 persons for those aged 45-64 years). Compared with non-OR inpatients, OR patients were less severely ill (20.5% had the highest severity of illness vs 24.6% for non-OR patients) and used more resources ($2900/day for OR patients vs $1400/day for non-OR patients). The 15 most expensive procedures accounted for half of all procedure-related hospitalization costs and one-fourth of total hospital costs. Volumes for 4 of the most expensive procedures increased between 1997 and 2007: 20% for percutaneous transluminal coronary angioplasty, 46% for cesarean delivery, 46% for knee replacement, and 45% for spinal fusion. The volume of percutaneous transluminal coronary angioplasty declined 20% from 2006 to 2007, compared with a 56% increase in the prior decade.
Procedures in the OR represent a large portion of hospital costs, and these costs are concentrated in few procedure types.
概述美国住院手术室手术情况。
设计、设置与患者：医疗成本与利用项目2007年全国住院患者样本数据，来自美国短期、急性护理、非联邦医院样本。
全国手术室手术总量及按手术类型划分的情况、资源使用和成本、最常见及最昂贵的手术以及趋势。
2007年共进行了1500万例手术室手术（每10000人中有495例手术）。仅26.4%的住院治疗涉及手术室手术；然而，与手术室相关的住院费用占医院总费用的46.8%（1610亿美元）。65岁及以上的患者接受手术室手术的可能性是其他患者的2至3倍（例如，65 - 84岁人群中每10000人有1327例手术，而45 - 64岁人群中每10000人有626例手术）。与非手术室住院患者相比，手术室患者病情较轻（20.5%的患者病情严重程度最高，而非手术室患者为24.6%），但使用的资源更多（手术室患者每天2900美元，非手术室患者每天1400美元）。15种最昂贵的手术占所有与手术相关住院费用的一半以及医院总费用的四分之一。1997年至2007年间，4种最昂贵手术的手术量有所增加：经皮腔内冠状动脉成形术增加了20%，剖宫产增加了46%，膝关节置换增加了46%，脊柱融合增加了45%。2006年至2007年，经皮腔内冠状动脉成形术的手术量下降了20%，而前十年则增加了56%。
手术室手术占医院成本的很大一部分，且这些成本集中在少数几种手术类型上。
