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对肉眼血尿患者进行快速通道泌尿外科护理既高效又具有成本效益：一项前瞻性干预研究的结果

Fast-track access to urologic care for patients with macroscopic haematuria is efficient and cost-effective: results from a prospective intervention study.

作者信息

Liedberg Fredrik, Gerdtham Ulf, Gralén Katarina, Gudjonsson Sigurdur, Jahnson Staffan, Johansson Irene, Hagberg Oskar, Larsson Staffan, Lind Anna-Karin, Löfgren Annica, Wanegård Jenny, Åberg Hanna, Nilbert Mef

机构信息

Department of Urology, Skåne University Hospital, Malmö, Sweden.

Department of Translational Medicine, Lund University, Malmö, Sweden.

出版信息

Br J Cancer. 2016 Sep 27;115(7):770-5. doi: 10.1038/bjc.2016.265. Epub 2016 Aug 25.

DOI:10.1038/bjc.2016.265
PMID:27560554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5046212/
Abstract

BACKGROUND

The delay between onset of macroscopic haematuria and diagnosis of bladder cancer is often long.

METHODS

We evaluated timely diagnosis and health-care costs for patients with macroscopic haematuria given fast-track access to diagnostics. During a 15-month period, a telephone hotline for fast-track diagnostics was provided in nine Swedish municipalities for patients aged ⩾50 years with macroscopic haematuria. The control group comprised 101 patients diagnosed with bladder cancer in the same catchment area with macroscopic haematuria who underwent regular diagnostic process.

RESULTS

In all 275 patients who called 'the Red Phone' hotline were investigated, and 47 of them (17%) were diagnosed with cancer and 36 of those had bladder cancer. Median time from patient-reported haematuria to diagnosis was 29 (interquartile range (IQR) 14-104) days and 50 (IQR 27-165) days in the intervention and the control group, respectively (P=0.03). The median health-care costs were lower in the intervention group (655 (IQR 655-655) EUR) than in the control group (767 (IQR 490-1096) EUR) (P=0.002).

CONCLUSIONS

Direct access to urologic expertise and fast-track diagnostics is motivated for patients with macroscopic haematuria to reduce diagnostic intervals and lower health-care expenditures.

摘要

背景

肉眼血尿出现至膀胱癌确诊之间的延迟通常较长。

方法

我们评估了为肉眼血尿患者提供快速诊断途径后的及时诊断情况及医疗费用。在15个月期间，瑞典9个市为年龄≥50岁的肉眼血尿患者设立了快速诊断电话热线。对照组包括在同一集水区被诊断为膀胱癌且有肉眼血尿并接受常规诊断流程的101例患者。

结果

拨打“红色电话”热线的275例患者均接受了调查，其中47例（17%）被诊断患有癌症，其中36例患有膀胱癌。干预组从患者报告血尿到诊断的中位时间为29天（四分位间距（IQR）14 - 104天），对照组为50天（IQR 27 - 165天）（P = 0.03）。干预组的中位医疗费用（655（IQR 655 - 655）欧元）低于对照组（767（IQR 490 - 1096）欧元）（P = 0.002）。

结论

对于肉眼血尿患者，直接获得泌尿外科专家的专业服务和快速诊断有助于缩短诊断间隔并降低医疗支出。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/dc9282c8589a/bjc2016265f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/ab5a76e677fc/bjc2016265f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/9b82678a2f9f/bjc2016265f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/dc9282c8589a/bjc2016265f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/ab5a76e677fc/bjc2016265f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/9b82678a2f9f/bjc2016265f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c04/5046212/dc9282c8589a/bjc2016265f3.jpg

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