Kwon Wooil, Jang Jin-Young, Park Jae Woo, Han In Woong, Kang Mee Joo, Kim Sun-Whe
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2014 Jan;86(1):7-15. doi: 10.4174/astr.2014.86.1.7. Epub 2014 Jan 1.
The consumers' preferences are not considered in developing or implementing new medical technologies. Furthermore, little efforts are made to investigate their demands. Therefore, their preferred surgical method and the factors affecting that preference were investigated in pancreatic surgery.
Six-hundred subjects including 100 medical personnel (MP) and 500 lay persons (LP) were surveyed. Questionnaire included basic information on different methods of distal pancreatectomy; open surgery (OS), laparoscopic surgery (LS), and robotic surgery (RS). Assuming they required the operation, participants were told to indicate their preferred method along with a reason and an acceptable cost for both benign and malignant conditions.
For benign disease, the most preferred method was LS. Limiting the choice to LS and RS, LS was preferred for cost and well-established safety and efficacy. OS was favored in malignant disease for the concern for radicality. Limiting the choice to LS and RS, LS was favored for its better-established safety and efficacy. The majority thought that LS and RS were both overpriced. Comparing MP and LP responses, both groups preferred LS in benign and OS in malignant conditions. However, LP more than MP tended to prefer RS under both benign and malignant conditions. LP thought that LS was expensive whereas MP thought the cost reasonable. Both groups felt that RS was too expensive.
Though efforts for development of novel techniques and broadening indication should be encouraged, still more investments and research should focus on LS and OS to provide optimal management and satisfaction to the patients.
在开发或实施新的医疗技术时未考虑消费者的偏好。此外,很少有人努力去调查他们的需求。因此,我们对胰腺手术中患者偏好的手术方法及其影响因素进行了调查。
对600名受试者进行了调查,其中包括100名医务人员(MP)和500名非专业人员(LP)。问卷包括关于不同远端胰腺切除术方法的基本信息;开放手术(OS)、腹腔镜手术(LS)和机器人手术(RS)。假设他们需要进行手术,要求参与者指出他们偏好的方法,并说明理由以及良性和恶性疾病情况下可接受的费用。
对于良性疾病,最受欢迎的方法是LS。若选择仅限于LS和RS,由于成本以及已确立的安全性和有效性,LS更受青睐。在恶性疾病中,由于对根治性的关注,OS更受青睐。若选择仅限于LS和RS,由于其更好确立的安全性和有效性,LS更受青睐。大多数人认为LS和RS都定价过高。比较MP和LP的回答,两组在良性疾病中都更喜欢LS,在恶性疾病中都更喜欢OS。然而,在良性和恶性疾病情况下,LP比MP更倾向于选择RS。LP认为LS昂贵,而MP认为成本合理。两组都觉得RS太贵。
虽然应鼓励开发新技术和扩大适应症的努力,但仍应更多地投资和研究集中在LS和OS上,以便为患者提供最佳的治疗和满意度。