Gutwein Luke G, Alvarez Juan F, Gutwein Jenny L, Kays David W, Islam Saleem
Division of Pediatric Surgery, Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA.
Am Surg. 2013 Sep;79(9):865-9. doi: 10.1177/000313481307900916.
Circumcision remains a controversial operation. Most procedures are performed in the neonatal period and avoid general anesthesia. Legislation driven by policy statements from the American Academy of Pediatrics led to significant changes in circumcisions in Florida with a shift to nonneonatal procedures as a result of costs. We sought to study the prevalence and financial implications of nonneonatal circumcisions in Florida. A retrospective population study was performed using the Florida Agency for Health Care Administration outpatient procedure database. We queried for patients 0 to 17 years of age undergoing circumcision between 2003 and 2008. Demographics, charges, and insurance status were analyzed. From 2003 to 2008, 31,741 outpatient circumcisions were performed. Publicly funded circumcisions accounted for 17,537 charging the state $6,263 on average for each circumcision at an expense of $111.8 million for the 5-year time period analyzed. Publicly funded circumcision procedures increased more than sixfold (P < 0.0001) than those covered by private insurance. Black circumcision procedures increased 77.3 per cent, whereas white circumcisions increased 28.7 per cent. There has been a significant increase in the number of nonneonatal circumcisions performed. This has resulted in an increase in economic health care. Public funding of neonatal circumcision could result in significant cost savings and avoid potential complications of general anesthesia.
包皮环切术仍然是一项存在争议的手术。大多数手术在新生儿期进行，且避免全身麻醉。在美国儿科学会政策声明推动下的立法导致佛罗里达州的包皮环切术发生了重大变化，由于成本原因，手术转向了非新生儿期手术。我们试图研究佛罗里达州非新生儿期包皮环切术的患病率及其财务影响。利用佛罗里达州医疗保健管理局的门诊手术数据库进行了一项回顾性人群研究。我们查询了2003年至2008年间接受包皮环切术的0至17岁患者。分析了人口统计学、收费情况和保险状况。2003年至2008年期间，共进行了31741例门诊包皮环切术。由公共资金资助的包皮环切术有17537例，在此期间，该州为每例包皮环切术平均花费6263美元，总计花费1.118亿美元。由公共资金资助的包皮环切术比由私人保险承保的手术增加了六倍多（P<0.0001）。黑人的包皮环切术增加了77.3%，而白人的包皮环切术增加了28.7%。非新生儿期包皮环切术的数量有显著增加。这导致了医疗保健方面的经济支出增加。对新生儿包皮环切术进行公共资金资助可能会大幅节省成本，并避免全身麻醉的潜在并发症。
