Pruzansky M E, Remer S, Freedman B
Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY 10028.
Health Serv Res. 1989 Dec;24(5):685-92.
Arthroscopic surgery of the knee has reduced in-hospital utilization of 37 percent for surgical treatment of internal derangements of the knee at The Mount Sinai Medical Center. In a study comparing arthrotomies of the knee in 1974 (N = 106) to arthroscopic surgery of the knee in 1984 (N = 221) it was found that while the average patient's age increased 4.39 years to 38.79 years (p less than 0.01) and the number of nonligament knee surgeries increased 108 percent, total annual inpatient hospital days fell to 459 in 1984, from 733 in 1974. The average length of stay in 1984 decreased to 2.07 days, from 6.91 days in 1974 (p less than 0.001). Ambulatory patients comprised 16 percent of the total in 1984, and there were none in 1974. New surgical techniques are reducing in-hospital usage and revenues. Due to the greater third-party reimbursement rate for outpatient operating room use as compared to per diem hospital reimbursement, efficient utilization of ambulatory operating rooms can help to compensate for decreased inpatient census.
在西奈山医疗中心，膝关节镜手术使膝关节内部紊乱的手术治疗的住院使用率降低了37%。在一项将1974年的膝关节切开术（N = 106）与1984年的膝关节镜手术（N = 221）进行比较的研究中发现，虽然患者的平均年龄增加了4.39岁，达到38.79岁（p小于0.01），非韧带膝关节手术的数量增加了108%，但1984年的年度住院总天数从1974年的733天降至459天。1984年的平均住院时间从1974年的6.91天降至2.07天（p小于0.001）。1984年门诊患者占总数的16%，而1974年没有门诊患者。新的手术技术正在减少医院的使用和收入。由于门诊手术室使用的第三方报销率高于每日住院报销率，高效利用门诊手术室有助于弥补住院人数的减少。
