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小儿鼻窦手术的成本(费用剖析)

The price of doing pediatric sinus procedures (a look at cost).

作者信息

Ho Brian, Liebman Robert, Hughes C Anthony

机构信息

Department of Pediatric Otolaryngology, Georgia Regents University, Augusta, GA, United States.

出版信息

Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1639-42. doi: 10.1016/j.ijporl.2013.07.001. Epub 2013 Aug 13.

Abstract

OBJECTIVE

Display the cost savings of minimal sterile covers and preparatory time while still maintaining optimal outcomes for sinus procedures. In-office non-sterile endoscopic sinus procedures have not shown a difference in infections and complications. Institutions continue to employ more "traditional" sterile preparation with similar procedures in the operating room. Multiple studies have also shown no significant difference in postoperative course when preoperative antibiotics are administered for sinus procedures.

METHODS

Endoscopic sinus procedures were selected (58 patients) to analyze itemized sterile costs. Drapes, gloves, gowns, and antibiotics were then tallied and compared to the same items for cochlear implants (14 procedures). The "sterile-prep" time was also analyzed and compared between the two procedures. Cost difference was analyzed.

RESULTS

Comparing the supplies used for sinus procedures (56) and cochlear implants, our average sinus cost was $10.19, compared to $34.64, with a difference of $24.45. This equated to a savings of $1418.00 in sinus procedure supplies that year. The difference in draping and scrubbing time showed a difference of 20 min between groups, equaling a value of $1760 difference/case. This calculated to a savings of $10,2080 for sinus operating room time. There was no difference in patient outcomes with this surgical preparatory approach.

CONCLUSION

Our analysis showed a large cost savings over a fiscal year in operative time and supplies. This did not compromise any patient outcomes given the already non-sterile nature of endoscopic sinus surgery. This practice can be adopted to greatly enhance efficiency without sacrificing surgical results.

摘要

目的

展示使用最少无菌覆盖物和准备时间所节省的成本,同时仍能保持鼻窦手术的最佳效果。门诊非无菌内镜鼻窦手术在感染和并发症方面未显示出差异。各机构在手术室对类似手术仍采用更“传统”的无菌准备方法。多项研究还表明,鼻窦手术术前使用抗生素时,术后病程无显著差异。

方法

选择内镜鼻窦手术患者(58例)分析逐项无菌成本。然后统计手术巾、手套、手术衣和抗生素的使用情况,并与人工耳蜗植入手术(14例)的相同项目进行比较。还对两种手术的“无菌准备”时间进行了分析和比较。分析成本差异。

结果

比较鼻窦手术(56例)和人工耳蜗植入手术所用耗材,鼻窦手术的平均成本为10.19美元,而人工耳蜗植入手术为34.64美元,相差24.45美元。这相当于该年鼻窦手术耗材节省了1418.00美元。铺巾和刷洗时间的差异显示两组相差20分钟,相当于每例相差1760美元。据此计算,鼻窦手术的手术室时间节省了102080美元。采用这种手术准备方法,患者的治疗效果没有差异。

结论

我们的分析表明,在一个财政年度内,手术时间和耗材方面可大幅节省成本。鉴于内镜鼻窦手术本就具有非无菌的性质,这并未影响任何患者的治疗效果。这种做法可在不牺牲手术结果的情况下大大提高效率。

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